Rabiner, Robert A. (Chelmsford, MA, US)
Hare, Bradley A. (Chelmsford, MA, US)

10/373134

03/17/2009

02/24/2003

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OmniSonics Medical Technologies, Inc. (Wilmington, MA, US)

600/459

600/439

A61B8/00; A61B8/14

600/437, 606/169, 606/171, 600/459, 600/439

1239451		September, 1917	Belz
1779478	Method of working metal rods, bars, and the like	October, 1930	Leech
1861769	Catheterizing instrument	June, 1932	Wappler
2199602	Method of forming tubes	May, 1940	Wright
2242120	Holder for piezoelectric devices	May, 1941	Gardiner
2270922	Piezoelectric crystal holder	January, 1942	Bechmann et al.
2321358	Art of mounting piezoelectric crystals	June, 1943	Bokovoy
2514080	Method of obtaining high velocity with crystals	July, 1950	Mason
2742076	Method of stretching tapered sheets	April, 1956	Klein
2838695	Multi-section quartz torsional transducers	June, 1958	Thurston
2843176	Draw-type tube straightener with clamping means allowing tube to be laterally inserted and removed	June, 1958	Franck
2917691	Automatic power and frequency control for electromechanical devices	December, 1959	De Prisco et al.
2990616	Ultrasonic cutting tool	July, 1961	Balamuth et al.	433/119
3056698	Method and apparatus for cleaning porous objects	October, 1962	Kleesattel et al.
3089790	Ultrasonic cleaning devices and method of cleaning	May, 1963	Balamuth et al.
3113225	Ultrasonic vibration generator	December, 1963	Kleesattel et al.
3132548	Pre-set torque release wrench	May, 1964	Livermont
3133351	Method and apparatus for sonic dental drilling	May, 1964	von Seggern
3202021	Torque release wrench	August, 1965	Livermont
3241780	Wire tensioning filament feeding apparatus	March, 1966	Kitselman
3304449	Apparatus for producing sonic and ultrasonic oscillations	February, 1967	Pohlman et al.
3315663	Bronchoscope having means for producing mechanical vibrations in the bronchial tract	April, 1967	Goldfarb
3401446	Method for delaminating articles	September, 1968	Obeda et al.
3433226	VIBRATORY CATHETERIZATION APPARATUS AND METHOD OF USING	March, 1969	Boyd
3438824	METHOD AND APPARATUS FOR JOINING A CLOSURE TO A CONTAINER BY HIGH FREQUENCY RADIAL VIBRATIONS	April, 1969	Balamuth
3486361	STRENGTHENING OF ELONGATED METAL SECTIONS	December, 1969	Vaneman et al.
3524085	SONIC TRANSDUCER	August, 1970	Shoh
3526219	METHOD AND APPARATUS FOR ULTRASONICALLY REMOVING TISSUE FROM A BIOLOGICAL ORGANISM	September, 1970	Balamuth	600/565
3528410	ULTRASONIC METHOD FOR RETINAL ATTACHMENT	September, 1970	Banko
3565062	ULTRASONIC METHOD AND APPARATUS FOR REMOVING CHOLESTEROL AND OTHER DEPOSITS FROM BLOOD VESSELS AND THE LIKE	February, 1971	Kuris	606/169
3589363	MATERIAL REMOVAL APPARATUS AND METHOD EMPLOYING HIGH FREQUENCY VIBRATIONS	June, 1971	Banko	604/22
3614484	ULTRASONIC MOTION ADAPTER FOR A MACHINE TOOL	October, 1971	Shoh
3660186	METHOD FOR BONDING WEBS EMPLOYING ULTRASONIC ENERGY	May, 1972	Sager et al.
3683736	ULTRASONIC PERFORATING OF A SHEET OF FILM, PAPER OR THE LIKE	August, 1972	Loose
3763680	METHOD AND APPARATUS FOR TREATING WIRE	October, 1973	Godfrey et al.
3805787	ULTRASONIC SURGICAL INSTRUMENT	April, 1974	Banko	604/22
3809977	ULTRASONIC KITS AND MOTOR SYSTEMS	May, 1974	Balamuth et al.
3840932	ULTRASONIC TOOTHBRUSH APPLICATOR	October, 1974	Balamuth et al.
3853130	STERILE HANDLING CATHETER ASSEMBLIES	December, 1974	Sheridan
3861391	APPARATUS FOR DISINTEGRATION OF URINARY CALCULI	January, 1975	Antonevich et al.	606/128
3890977	Kinetic memory electrodes, catheters and cannulae	June, 1975	Wilson
3906954	Ophthalmic liquifaction pump	September, 1975	Baehr et al.
3939033	Ultrasonic welding and cutting apparatus	February, 1976	Grgach et al.
3955662	Torque limiting wrench	May, 1976	Thackston
3962898	Apparatus for the manufacture of wire	June, 1976	Tillmann
3967621	Needle holder for medical syringes, vials, or the like	July, 1976	Schwarz
3980906	Ultrasonic motor-converter systems	September, 1976	Kuris et al.
3988782	Non-antigenic, non-thrombogenic infection-resistant grafts from umbilical cord vessels and process for preparing and using same	November, 1976	Dardik et al.
3990452	Medical machine for performing surgery and treating using ultrasonic energy	November, 1976	Murry et al.
3991929	Coating and bonding of metals	November, 1976	Smith
4011474	Piezoelectric stack insulation	March, 1977	O'Neill
4012174	Fuel priming pump	March, 1977	Seibel et al.
4012647	Ultrasonic motors and converters	March, 1977	Balamuth et al.
4044174	Ultrasonically smoothing a magnetic layer on a web	August, 1977	Carr
4063557	Ultrasonic aspirator	December, 1977	Wuchinich et al.
4069541	Cleaning method and apparatus	January, 1978	Williams et al.
4083996	Novel hydroxamic acid derivatives and medicaments for treatment of urolithiasis and pyelonephrosis comprising such derivatives	April, 1978	Tanaka et al.
4136700	Neurosonic aspirator	January, 1979	Broadwin et al.	606/169
4143130	Method for treating kidney stones	March, 1979	Imondi et al.
4144646	Torsional ultrasonic vibrators	March, 1979	Takemoto et al.
4157396	Hydroxamic acid derivatives and medicaments for treatment of urolithiasis and pyelonephrosis comprising such derivatives	June, 1979	Tanaka et al.
4164524	Treatment of blood containing vessels	August, 1979	Ward et al.
4169984	Ultrasonic probe	October, 1979	Parisi
4174410	Coating and bonding of metals	November, 1979	Smith
4178935	Method and apparatus for disintegration of urinary concretions	December, 1979	Gekhman et al.
4203429	Method of removing concretions from the ureter	May, 1980	Vasilevsky et al.
4203444	Surgical instrument suitable for closed surgery such as of the knee	May, 1980	Bonnell et al.
4223676	Ultrasonic aspirator	September, 1980	Wuchinich et al.
4225803	Apparatus for removing material coatings from interior surfaces of containers	September, 1980	Goof
4236510	Ultrasonic tooth cleaning apparatus	December, 1980	Hatter et al.	601/2
4248232	Method of dissolving the bond between interconnected components	February, 1981	Engelbrecht et al.
4265928	Anti-thrombogenic retentive catheter	May, 1981	Braun
4280233	Bone connective prosthesis comprising a reinforcement element carrying a polymer layer having a varying modulus of elasticity	July, 1981	Raab
4300564	Forceps for extracting stones in the pelvis of a kidney	November, 1981	Furihata
4311147	Apparatus for contact-free disintegration of kidney stones or other calculi	January, 1982	Hausler
4315181	Ultrasonic resonator (horn) with skewed slots	February, 1982	Holze, Jr.
4316465	Ophthalmic handpiece with pneumatically operated cutter	February, 1982	Dotson, Jr.
4326903	Method for securing parts together by ultrasonic energy	April, 1982	Summo
4334168	High frequency, thermostatically self controlled oscillator	June, 1982	Besson et al.
4335426	Remote processor initialization in a multi-station peer-to-peer intercommunication system	June, 1982	Maxwell et al.
4352570	Vibratory treatment apparatus and method	October, 1982	Firth
4356590	Carpet cleaning system	November, 1982	Goldsmith
4363992	Resonator exhibiting uniform motional output	December, 1982	Holze, Jr.
4368410	Ultrasound therapy device	January, 1983	Hance et al.
4385413	Carpet cleaning system	May, 1983	Goldsmith
4393734	Combined torque limiting and marking wrench	July, 1983	Thorn et al.
4395392	Method for treating kidney stones	July, 1983	Wolgemuth
4399003	Method and kit for diagnosing a patient's proneness to develop calcium oxalate kidney stones	August, 1983	Sarig et al.
4414045	High speed ultrasonic bonding	November, 1983	Wang et al.
4425115	Ultrasonic resonant vibrator	January, 1984	Wuchinich
4428748	Combined ultrasonic emulsifier and mechanical cutter for surgery	January, 1984	Peyman et al.
4445509	Method and apparatus for removal of enclosed abnormal deposits	May, 1984	Auth
4447455	Oral urolithiasis remedy	May, 1984	Madaus et al.
4462242	Method for wire drawing	July, 1984	Morgenthaler
4467678	Torque wrench	August, 1984	Lindholm
4474180	Apparatus for disintegrating kidney stones	October, 1984	Angulo	128/328
4479585	Tamper resistant safety closure and closure-container combination	October, 1984	Sandhaus
4480642	Dilation device for the cervix	November, 1984	Stoy et al.
4483571	Ultrasonic processing device	November, 1984	Mishiro
4486680	Ultrasonic piezoelectric disintegrater	December, 1984	Bonnet et al.	310/323.19
4493694	Surgical pre-aspirator	January, 1985	Wuchinich	604/22
4498025	Tuning fork	February, 1985	Takahashi
4504264	Apparatus for and method of removal of material using ultrasonic vibraton	March, 1985	Kelman	604/22
4516398	Method of use of an ultrasonic surgical pre-aspirator having a orifice by-pass	May, 1985	Wuchinich
4523122	Piezoelectric ultrasonic transducers having acoustic impedance-matching layers	June, 1985	Tone et al.
4526571	Curved ultrasonic surgical aspirator	July, 1985	Wuchinich	604/22
4529115	Thermally assisted ultrasonic welding apparatus and process	July, 1985	Renshaw et al.
4530138	Method of making a transducer assembly	July, 1985	Ritter
4534819	Woven textile fabric having an ultrasonically cut and sealed edge and apparatus and process for producing same	August, 1985	Payet et al.
4535659	Torque limiting wrench with an audio alarm	August, 1985	Yang
4535759	Ultrasonic medical instrument	August, 1985	Polk et al.	128/24A
4571520	Ultrasonic probe having a backing member of microballoons in urethane rubber or thermosetting resin	February, 1986	Saito et al.
4572041	Torque limiting wrench	February, 1986	Rissmann
4576177	Catheter for removing arteriosclerotic plaque	March, 1986	Webster, Jr.
4583365	Reticulated electrothermal fluid motor	April, 1986	John
4587958	Ultrasonic surgical device	May, 1986	Noguchi et al.
4589415	Method and system for fragmenting kidney stones	May, 1986	Haaga
4601705	Steerable and aimable catheter	July, 1986	McCoy
4603694	Arthroscopic shaver	August, 1986	Wheeler
4605454	Method of ultrasonically bonding nonwoven webs	August, 1986	Sayovitz et al.
4607185	Ultrasonic horn assembly	August, 1986	Elbert et al.
4609368	Pneumatic ultrasonic surgical handpiece	September, 1986	Dotson, Jr.
4620545	Non-invasive destruction of kidney stones	November, 1986	Shene et al.
4633119	Broadband multi-resonant longitudinal vibrator transducer	December, 1986	Thompson
4634420	Apparatus and method for removing tissue mass from an organism	January, 1987	Spinosa et al.	604/22
4642509	Ultrasonic motor using bending, longitudinal and torsional vibrations	February, 1987	Kumada
4643717	Aspiration fitting adaptor	February, 1987	Cook et al.
4647336	Rebuildable support assembly	March, 1987	Coenen et al.
4647871	Adaptive impedance mismatch detector system	March, 1987	Turner, Jr.
4651043	Resonator exhibiting uniform motional output	March, 1987	Harris et al.
4652785	Acoustic piezoelectric power transducer	March, 1987	Gabriel et al.
4652786	Torsional vibration apparatus	March, 1987	Mishiro
4655104	Adjustable torque wrench	April, 1987	Blattner
4663556	Torsional mode ultrasonic vibrator	May, 1987	Kumada
4676975	Thermoplastic polyurethane anticoagulant alloy coating	June, 1987	McGary et al.
4678993	Distance measuring device operating with torsional ultrasonic waves detected without mode conversion	July, 1987	Vinnemann et al.
4688454	Open-ended, high torque wrench for use on nuts to which there is limited access	August, 1987	Scull
4690722	Ultrasonic apparatus for joining and severing sheet material	September, 1987	Flood
4692139	Catheter for effecting removal of obstructions from a biological duct	September, 1987	Stiles
4696299	Non-invasive destruction of kidney stones	September, 1987	Shene et al.
4702236	Revision arthroplasty method and related instrument	October, 1987	Tarabichy et al.
4704131	Medical materials	November, 1987	Noishiki et al.
4704573	Impedance mismatch detector	November, 1987	Turner, Jr.
4708127	Ultrasonic generating system with feedback control	November, 1987	Abdelghani
4713132	Apparatus and method for ultrasonic bonding of a moving web	December, 1987	Abel et al.
4715078	Paperboard edge buffer and cleaner	December, 1987	Howard et al.
4718907	Vascular prosthesis having fluorinated coating with varying F/C ratio	January, 1988	Karwoski et al.
4730614	Device for advancing an electrode-holder element in an apparatus generating pulses for the destruction of targets such as kidney stones	March, 1988	Lacruche et al.
4732152	Device for implantation and a method of implantation in a vessel using such device	March, 1988	Wallsten et al.
4732156	Ultrasonic endoscope	March, 1988	Nakamura
4735625	Bone cement reinforcement and method	April, 1988	Davidson
4738666	Variable diameter catheter	April, 1988	Fuqua
4738667	Preformed catheter assembly	April, 1988	Galloway
4747820	Irrigation/aspiration manifold and fittings for ultrasonic surgical aspiration system	May, 1988	Hornlein et al.
4748985	Ultrasonic imaging apparatus having circulating cooling liquid for cooling ultrasonic transducers thereof	June, 1988	Nagasaki
4748986	Floppy guide wire with opaque tip	June, 1988	Morrison et al.
4749437	Variably-weighted ultrasonic welding horn	June, 1988	Welter
4750488	Vibration apparatus preferably for endoscopic ultrasonic aspirator	June, 1988	Wuchinich et al.
4750902	Endoscopic ultrasonic aspirators	June, 1988	Wuchinich et al.
4751916	Ultrasonic tool	June, 1988	Bory
4756304	Arthroscopic video camera system	July, 1988	Watanabe
4756309	Endoscope for removal of tissue	July, 1988	Sachse et al.
4758222	Steerable and aimable catheter	July, 1988	McCoy
4758293	Ultrasonic bonding apparatus and method	July, 1988	Samida
4762668	Venturi flow nozzle ultrasonic cleaning device	August, 1988	Loose et al.
4770730	Ultrasonic welding method for soft elastic foam body	September, 1988	Abe
4771202	Tuning fork resonator	September, 1988	Takahashi
4771782	Method and assembly for introducing multiple catheters into a biological vessel	September, 1988	Millar
4791915	Ultrasound therapy device	December, 1988	Barsotti et al.
4794912	Borescope or endoscope with fluid dynamic muscle	January, 1989	Lia
4823723	Trolling rig for fishing boats	April, 1989	Brooks
4823783	Adhesive-free bonding of continuously moving webs to form laminate web and products cut therefrom	April, 1989	Willhite, Jr. et al.
4825851	Method for comminuting kidney stones	May, 1989	Cocks et al.
4828052	Ultrasonic drilling apparatus	May, 1989	Duran et al.
4830002	Instrument grip	May, 1989	Semm
4834102	Endoscope for transesophageal echocardiography	May, 1989	Schwarzchild et al.
4838853	Apparatus for trimming meniscus	June, 1989	Parisi	604/22
4838859	Steerable catheter	June, 1989	Strassmann
4844081	Device for disintegrating kidney stones by means of shock waves	July, 1989	Northeved et al.
4846161	Method and apparatus for removing prosthetic cement	July, 1989	Roger
4846174	Angioplasty dilating guide wire	July, 1989	Willard et al.
4846790	Ultrasonic surgical system with irrigation manifold	July, 1989	Hornlein et al.
4850358	Method and assembly for introducing multiple devices into a biological vessel	July, 1989	Millar
4862573	Medical sampling needle removal and disposal device	September, 1989	Kelson et al.
4866491	Heterojunction field effect transistor having gate threshold voltage capability	September, 1989	Solomon et al.
4867141	Medical treatment apparatus utilizing ultrasonic wave	September, 1989	Nakada et al.	601/4
4870953	Intravascular ultrasonic catheter/probe and method for treating intravascular blockage	October, 1989	DonMicheal et al.	606/128
4872333	Wire drawing die	October, 1989	Burnand
4873969	Method and apparatus for removal of bone cement	October, 1989	Huebsch
4877037	Tissue or mucus sampling device	October, 1989	Ko et al.
4880011	Ultrasonic endoscope apparatus	November, 1989	Imade et al.
4881761	Irrigation tubing connector for an ultrasonic surgical system	November, 1989	Hornlein et al.
4882777	Catheter	November, 1989	Narula
4885499	Ultrasonic driven type motor	December, 1989	Ueha et al.
4886060	Equipment for use in surgical operations to remove tissue	December, 1989	Wiksell
4886491	Liposuction procedure with ultrasonic probe	December, 1989	Parisi et al.	304/22
4892089	Method for comminuting kidney stones	January, 1990	Cocks et al.
4904391	Method and apparatus for removal of cells from bone marrow	February, 1990	Freeman
4907572	Vibrational method for accelerating passage of stones from ureter	March, 1990	Borodulin et al.
4909789	Observation assisting forceps	March, 1990	Taguchi et al.
4917104	Electrically insulated "J" stiffener wire	April, 1990	Rebell
4920954	Ultrasonic device for applying cavitation forces	May, 1990	Alliger et al.	128/24A
4922902	Method for removing cellular material with endoscopic ultrasonic aspirator	May, 1990	Wuchinich et al.	604/22
4924863	Angioplastic method for removing plaque from a vas	May, 1990	Sterzer
4931047	Method and apparatus for providing enhanced tissue fragmentation and/or hemostasis	June, 1990	Broadwin et al.	604/22
4931049	Catheter coupling system	June, 1990	Klimas
4936281	Ultrasonically enhanced RF ablation catheter	June, 1990	Stasz
4960410	Flexible tubular member for catheter construction	October, 1990	Pinchuk
4961424	Ultrasonic treatment device	October, 1990	Kubota et al.	128/24A
4962755	Method for performing endarterectomy	October, 1990	King et al.	601/2
4963151	Reinforced bone cement, method of production thereof and reinforcing fiber bundles therefor	October, 1990	Ducheyne et al.
4966131	Ultrasound power generating system with sampled-data frequency control	October, 1990	Houghton et al.
4966148	Assembly for positioning diagnostic devices in a biological vessel	October, 1990	Millar
4974581	Ultrasonic knife	December, 1990	Wiksell
4978333	Resonator for surgical handpiece	December, 1990	Broadwin et al.
4979952	Ultrasonic vibration treatment apparatus	December, 1990	Kubota et al.
4986808	Magnetostrictive transducer	January, 1991	Broadwin et al.
4989583	Ultrasonic cutting tip assembly	February, 1991	Hood	128/24A
4989588	Medical treatment device utilizing ultrasonic wave	February, 1991	Kubota et al.
5003965	Medical device for ultrasonic treatment of living tissue and/or cells	April, 1991	Talish et al.
5003990	Apparatus for implanting electrodes and the like in animal bodies	April, 1991	Osypka
5015221	Differential steering mechanism	May, 1991	Smith
5015227	Apparatus for providing enhanced tissue fragmentation and/or hemostasis	May, 1991	Broadwin et al.	604/22
5017379	Drug units and methods for treating blood clots	May, 1991	Lemelson
5019083	Implanting and removal of orthopedic prostheses	May, 1991	Klapper et al.
5024234	Ultrasonic imaging catheter with guidewire channel	June, 1991	Leary et al.
5026387	Method and apparatus for ultrasonic surgical cutting and hemostatis	June, 1991	Thomas	606/169
5027792	Endoscopic revision hip surgery device	July, 1991	Meyer
5040548	Angioplasty mehtod	August, 1991	Yock
5045054	Apparatus for implantation and extraction of osteal prostheses	September, 1991	Hood et al.
5046497	Structure for coupling a guidewire and a catheter	September, 1991	Millar
5049157	Reinforced bone cement	September, 1991	Mittelmeier et al.
5054492	Ultrasonic imaging catheter having rotational image correlation	October, 1991	Scribner et al.
5055101	Variable shape guide apparatus	October, 1991	McCoy
5057106	Microwave balloon angioplasty	October, 1991	Kasevich et al.
5057119	Apparatus and methods for attaching and detaching an ultrasonic actuated blade/coupler and an acoustical mount therefor	October, 1991	Clark et al.	606/169
5057182	Ultrasonic comb horn and methods for using same	October, 1991	Wuchinich	156/580.1
5058570	Ultrasonic surgical apparatus	October, 1991	Idemoto et al.
5059210	Apparatus and methods for attaching and detaching an ultrasonic actuated blade/coupler and an acoustical mount therefor	October, 1991	Clark et al.	606/169
5061273	Angioplasty apparatus facilitating rapid exchanges	October, 1991	Yock
5062827	Device in ultrasonic aspirators	November, 1991	Wiksell	604/22
5064765	Assay for determining the propensity of a person to form kidney stones	November, 1991	Karasikov et al.
5069664	Intravascular ultrasonic angioplasty probe	December, 1991	Guess et al.
5076276	Ultrasound type treatment apparatus	December, 1991	Sakurai et al.
5102403	Therapeutic medical instrument for insertion into body	April, 1992	Alt
5106741	Tissue plasminogen activator (TPA) analogs	April, 1992	Marotti et al.
5108238	Torque limiting bolt for power wrench tightening	April, 1992	Ewing
5109830	Apparatus for navigation of body cavities	May, 1992	Cho
5112300	Method and apparatus for controlling ultrasonic fragmentation of body tissue	May, 1992	Ureche	604/22
5116343	Device for disintegrating concretions disposed in body cavities	May, 1992	Ams et al.	606/128
5122122	Locking trocar sleeve	June, 1992	Allgood
5123903	Disposable aspiration sleeve for ultrasonic lipectomy	June, 1992	Quaid et al.
5127405	Biomedical fiber optic probe with frequency domain signal processing	July, 1992	Alcala et al.
5129914	Acupuncture needle container and insertion tube	July, 1992	Choi
5139496	Ultrasonic freeze ablation catheters and probes	August, 1992	Hed
5139509	Phacoemulsification system with handpiece simulator	August, 1992	Fischer et al.
5147316	Laparoscopic trocar with self-locking port sleeve	September, 1992	Castillenti
5151085	Apparatus for generating ultrasonic oscillation	September, 1992	Sakurai et al.
5151099	Tool for removal of plastics material	September, 1992	Young et al.
5152200	Torque signalling wrench	October, 1992	Kaplan
5152748	Medical catheters thermally manipulated by fiber optic bundles	October, 1992	Chastagner
5156143	Ultrasonic percussion device	October, 1992	Bocquet et al.
5163421	In vivo ultrasonic system with angioplasty and ultrasonic contrast imaging	November, 1992	Bernstein et al.	128/24
5167619	Apparatus and method for removal of cement from bone cavities	December, 1992	Wuchinich	604/22
5169386	Method and catheter for dilatation of the lacrimal system	December, 1992	Becker et al.
5171387	Ultrasonic comb horn and methods for using same	December, 1992	Wuchinich	156/73.3
5175492	Calibration and error correction for electrical-source-to-E/O-device impedance mismatch and O/E-device-to-electrical-receiver impedance mismatch in a lightwave component analyzer	December, 1992	Wong et al.
5176141	Disposable intra-luminal ultrasonic instrument	January, 1993	Bom et al.
5176677	Endoscopic ultrasonic rotary electro-cauterizing aspirator	January, 1993	Wuchinich	604/356
5180363	Operation device	January, 1993	Idemoto et al.	202/32
5190517	Electrosurgical and ultrasonic surgical system	March, 1993	Zieve et al.	604/22
5193525	Antiglare tip in a sheath for an endoscope	March, 1993	Silverstein et al.
5195955	Device for removal of embolic debris	March, 1993	Don Michael
5201315	Ultrasound imaging sheath	April, 1993	Griffith
5201316	Guide wire receptacle for catheters having rigid housings	April, 1993	Pomeranz et al.
5203338	Vascular catheter having low-profile distal end	April, 1993	Jang
5209719	Ultrasonic recanalization system	May, 1993	Baruch et al.
5217465	Flexible and steerable aspiration tip for microsurgery	June, 1993	Steppe
5221282	Tapered tip ultrasonic aspirator	June, 1993	Wuchinich	606/99
5222937	Ultrasonic treatment apparatus	June, 1993	Kagawa
5222974	Hemostatic puncture closure system and method of use	June, 1993	Kensey et al.
5231080	Method for the treatment of atherosclerosis, thrombosis, and peripheral vessel disease	July, 1993	Scholkens
5231994	Hose or tubular guide catheter	August, 1993	Harmjanz
5232451	Locking trocar sleeve	August, 1993	Freitas et al.
5235964	Flexible probe apparatus	August, 1993	Abenaim
5240437	Torqueable guide wire assembly with electrical functions, male and female connectors for use therewith and system and apparatus for utilizing the same	August, 1993	Christian
5243997	Vibrating device for a guide wire	September, 1993	Uflacker et al.	600/565
5248296	Ultrasonic device having wire sheath	September, 1993	Alliger
5249580	Method for ultrasound imaging	October, 1993	Griffith
5255551	Precious metal wire drawing machine and method	October, 1993	Vetter
5255669	Ultrasonic treatment apparatus	October, 1993	Kubota et al.
5261805	Die for extrusion of blown plastic film	November, 1993	Gates
5261877	Method of performing a thrombectomy procedure	November, 1993	Fine et al.
5263928	Catheter and endoscope assembly and method of use	November, 1993	Trauthen et al.
5263932	Bailout catheter for fixed wire angioplasty	November, 1993	Jang
5267954	Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels	December, 1993	Nita	604/22
5267958	Exchange catheter having exterior guide wire loops	December, 1993	Buchbinder et al.
5267982	Variable shaped catheter system and method for catheterization	December, 1993	Sylvanowicz
5269297	Ultrasonic transmission apparatus	December, 1993	Weng et al.	128/24AA
5271735	Exterior antimigration refinements for self-cleaning indwelling therapeutic articles	December, 1993	Greenfield et al.	604/266
5274297	Quartz resonator vibrating in a fundamental torsion mode	December, 1993	Hermann et al.
5285795	Percutaneous discectomy system having a bendable discectomy probe and a steerable cannula	February, 1994	Ryan et al.
5287775	Torque limiting drawing holder nut wrench	February, 1994	Moore
5290229	Transformable catheter and method	March, 1994	Paskar
5300021	Apparatus for removing cores of thermoplastic and elastomeric material	April, 1994	Wuchinich	604/22
5300032	Catheter introducer with flexible tip	April, 1994	Hibbs et al.
5300085	Angioplasty apparatus facilitating rapid exchanges and method	April, 1994	Yock
5304115	Ultrasonic angioplasty device incorporating improved transmission member and ablation probe	April, 1994	Pflueger et al.	604/22
5304131	Catheter	April, 1994	Paskar
5304199	Apparatus for arterial total occlusion plaque separation	April, 1994	Myers
5306261	Catheter with collapsible wire guide	April, 1994	Alliger et al.
5307816	Thrombus resolving treatment apparatus	May, 1994	Hashimoto et al.
5311858	Imaging tissue or stone removal basket	May, 1994	Adair
5312328	Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels	May, 1994	Nita et al.	604/22
5312329	Piezo ultrasonic and electrosurgical handpiece	May, 1994	Beaty et al.	604/22
5312427	Device and method for directional rotational atherectomy	May, 1994	Shturman
5315996	Torquable catheter and method	May, 1994	Lundquist
5318528	Steerable surgical devices	June, 1994	Heaven et al.
5319278	Longitudinal-torsional resonance ultrasonic motor with improved support structure	June, 1994	Myohga et al.
5323902	Safety device for holding and retaining hyposyringes and the like	June, 1994	Palmer et al.
5324255	Angioplasty and ablative devices having onboard ultrasound components and devices and methods for utilizing ultrasound to treat or prevent vasopasm	June, 1994	Passafaro et al.
5324299	Ultrasonic scalpel blade and methods of application	June, 1994	Davison et al.	606/167
5325698	Stepped extrusion die assembly	July, 1994	Nagpal et al.
5326342	Ultrasonic angioplasty device incorporating all ultrasound transmission member made at least partially from a superlastic metal alloy	July, 1994	Pflueger et al.
5329927	Apparatus and method for locating an interventional medical device with a ultrasound color imaging system	July, 1994	Gardineer et al.
5330444	Catheter tip with a low friction lining and method of use	July, 1994	Webler et al.
5330482	Endoscopic extraction devices, wire basket stone extractors, stent retrievers, snares and method of constructing the same	July, 1994	Gibbs et al.
5330497	Locking trocar sleeve	July, 1994	Freitas et al.
5331242	Vibrating tine resonators and methods for torsional and normal dynamic vibrating mode	July, 1994	Petri
5334160	Intravascular catheter with sleeve and method for use thereof	August, 1994	Ellis
5334167	Modified nasogastric tube for use in enteral feeding	August, 1994	Cocanower
5334183	Endoscopic electrosurgical apparatus	August, 1994	Wuchinich	606/46
5336184	Rapid exchange catheter	August, 1994	Teirstein
5336234	Method and apparatus for dilatation of a stenotic vessel	August, 1994	Vigil et al.
5336699	Bone cement having chemically joined reinforcing fillers	August, 1994	Cooke et al.
5342292	Ultrasonic ablation device adapted for guidewire passage	August, 1994	Nita et al.	604/22
5344395	Apparatus for intravascular cavitation or delivery of low frequency mechanical energy	September, 1994	Whalen et al.
5350395	Angioplasty apparatus facilitating rapid exchanges	September, 1994	Yock
5351679	Surgical endoscopic retractor instrument	October, 1994	Mayzels et al.
5353798	Intravascular imaging apparatus and methods for use and manufacture	October, 1994	Sieben
5356385	Hypodermic needle sheath holder	October, 1994	Latini
5356421	Safety trocar with locking handles	October, 1994	Castro
5358505	Tapered tip ultrasonic aspiration method	October, 1994	Wuchinich	606/99
5362309	Apparatus and method for enhanced intravascular phonophoresis including dissolution of intravascular blockage and concomitant inhibition of restenosis	November, 1994	Carter
5366490	Medical probe device and method	November, 1994	Edwards et al.	607/99
5366899	Methods of diagnosing complicated urolithiasis and predicting urolithiasis	November, 1994	Shabalin et al.
5368557	Ultrasonic ablation catheter device having multiple ultrasound transmission members	November, 1994	Nita et al.
5368558	Ultrasonic ablation catheter device having endoscopic component and method of using same	November, 1994	Nita	604/22
5370602	Phacoemulsification probe circuit with pulse width Modulating drive	December, 1994	Kepley
5380273	Vibrating catheter	January, 1995	Dubrul et al.	604/22
5380274	Ultrasound transmission member having improved longitudinal transmission properties	January, 1995	Nita	604/22
5382228	Method and device for connecting ultrasound transmission member (S) to an ultrasound generating device	January, 1995	Nita et al.	604/22
5385372	Luer connector with integral closure	January, 1995	Utterberg
5387190	Probe break detector for an ultrasonic aspirator	February, 1995	Gotanda et al.
5387197	Trocar safety shield locking mechanism	February, 1995	Smith et al.
5388569	Phacoemulsification probe circuit with switch drive	February, 1995	Kepley
5390678	Method and device for measuring ultrasonic activity in an ultrasound delivery system	February, 1995	Gesswein et al.
5391144	Ultrasonic treatment apparatus	February, 1995	Sakurai et al.
5396902	Steerable stylet and manipulative handle assembly	March, 1995	Brennen et al.
5397293	Ultrasonic device with sheath and transverse motion damping	March, 1995	Alliger et al.	601/2
5397301	Ultrasonic angioplasty device incorporating an ultrasound transmission member made at least partially from a superelastic metal alloy	March, 1995	Pflueger et al.	604/22
5402799	Guidewire having flexible floppy tip	April, 1995	Colon et al.
5403324	Flexible catheter with stone basket and ultrasonic conductor	April, 1995	Ciervo et al.
5405318	Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels	April, 1995	Nita	604/22
5405341	Catheter with multiple lumens	April, 1995	Martin
5406503	Control system for calibrating and driving ultrasonic transducer	April, 1995	Williams, Jr. et al.
5409112	Needle disposal system comprised of blood collection holder and companion biohazard receptacle	April, 1995	Sagstetter
5417654	Elongated curved cavitation-generating tip for disintegrating tissue	May, 1995	Kelman	604/22
5417672	Connector for coupling an ultrasound transducer to an ultrasound catheter	May, 1995	Nita et al.	604/533
5419761	Liposuction apparatus and associated method	May, 1995	Narayanan et al.	604/22
5421338	Acoustic imaging catheter and the like	June, 1995	Crowley et al.
5421829	Ultrasonic surgical handpiece and an energy initiator	June, 1995	Olichney et al.
5423797	Acoustic catheter with rotary drive	June, 1995	Adrian et al.
5423838	Atherectomy catheter and related components	June, 1995	Willard
5425704	Apparatus for generating ultrasonic oscillation	June, 1995	Sakurai et al.
5427118	Ultrasonic guidewire	June, 1995	Nita et al.	128/772
5429136	Imaging atherectomy apparatus	July, 1995	Milo et al.
5431664	Method of tuning ultrasonic devices	July, 1995	Ureche et al.
5434827	Matching layer for front acoustic impedance matching of clinical ultrasonic tranducers	July, 1995	Bolorforosh
5443443	Atherectomy system	August, 1995	Shiber
5443456	Catheter with collapsible wire guide	August, 1995	Alliger et al.
5443457	Tracking tip for a short lumen rapid exchange catheter	August, 1995	Ginn et al.
5443468	Method for drilling a bore in bone using a compaction drill	August, 1995	Johnson
5445617	Automatic retractable safety penetrating instrument for portal sleeve introduction and method of use	August, 1995	Yoon
5447509	Ultrasound catheter system having modulated output with feedback control	September, 1995	Mills et al.	606/1
5449369	Flexible elongate device having a vibratory impact tip and method of its use	September, 1995	Imran
5451233	Angioplasty apparatus facilitating rapid exchanges	September, 1995	Yock
5452611	Ultrasonic level instrument with dual frequency operation	September, 1995	Jones et al.
5454373	Medical acoustic imaging	October, 1995	Koger et al.
5458584	Intravascular catheter having an enclosed proximal end and a reduced profile distal region	October, 1995	Ginn et al.
5458612	Prostatic ablation method and apparatus for perineal approach	October, 1995	Chin	606/192
5460595	Multi-frequency ultrasound therapy systems and methods	October, 1995	Hall et al.
5462530	Intravascular catheter with bailout feature	October, 1995	Jang
5464016	Medical acoustic imaging catheter and guidewire	November, 1995	Nicholas et al.
5464409	Uterine manipulator and protector	November, 1995	Mohajer
5464438	Gold coating means for limiting thromboses in implantable grafts	November, 1995	Menaker
5467674	Combined torque limiting and marking wrench	November, 1995	Thorn
5469853	Bendable ultrasonic probe and sheath for use therewith	November, 1995	Law et al.	128/662.06
5470322	Reinforced multilumen catheter for axially varying stiffness	November, 1995	Horzewski et al.
5472441	Device for treating cancer and non-malignant tumors and methods	December, 1995	Edwards et al.	606/41
5474075	Brush-tipped catheter for ultrasound imaging	December, 1995	Goldberg et al.
5474530	Angioplasty and ablative devices having onboard ultrasound components and devices and methods for utilizing ultrasound to treat or prevent vasospasm	December, 1995	Passafaro et al.
5474531	Apparatus and method for enhanced intravascular phonophoresis including dissolution of intravascular blockage and concomitant inhibition of restenosis	December, 1995	Carter
5478353	Suture tie device system and method for suturing anatomical tissue proximate an opening	December, 1995	Yoon
5478558	Method of dissolving venous Thrombi using drug containing activated Protein C	December, 1995	Eibl et al.
5484398	Methods of making and using ultrasonic handpiece	January, 1996	Stoddard	604/22
5492001	Method and apparatus for working burred portion of workpiece	February, 1996	Sasaki et al.
5498236	Vibrating catheter	March, 1996	Dubrul et al.	604/22
5501227	Angioplasty apparatus facilitating rapid exchange and method	March, 1996	Yock
5505714	Non-rotational catheter compression clamp	April, 1996	Dassa et al.
5507738	Ultrasonic vascular surgical system	April, 1996	Ciervo
5512037	Percutaneous surgical retractor	April, 1996	Russell et al.
5516043	Ultrasonic atomizing device	May, 1996	Manna et al.	239/102.2
5524620	Ablation of blood thrombi by means of acoustic energy	June, 1996	Rosenschein
5524635	Apparatus for advancing a guide wire	June, 1996	Uflacker et al.
5527273	Ultrasonic lipectomy probe and method for manufacture	June, 1996	Manna et al.
5527279	Control mechanism and system and method for steering distal extremity of a flexible elongate member	June, 1996	Imran
5531664	Bending actuator having a coil sheath with a fixed distal end and a free proximal end	July, 1996	Adachi et al.
5536250	Perfusion shunt device and method	July, 1996	Klein et al.
5540656	Ultrasonic angioplasty device having surface disruptions	July, 1996	Pflueger et al.
5542917	Ultrasound delivery catheters incorporating improved distal tip construction	August, 1996	Nita et al.
5549563	Reinforcing insert for uterine manipulator	August, 1996	Kronner
5549576	Vascular introducer valve with proximal self-lubrication	August, 1996	Patterson et al.
5562620	Perfusion shunt device having non-distensible pouch for receiving angioplasty balloon	October, 1996	Klein et al.
5569276	Intravascular catheter having combined imaging abrasion head	October, 1996	Jang et al.
5571014	Disposable torque limiting wrench	November, 1996	Gregory, Jr. et al.
5571085	Steerable open lumen catheter	November, 1996	Accisano, III
5575772	Albation catheters	November, 1996	Lennox
5580962	Parenterally administrable drug having thrombolytic activity and containing protein C	December, 1996	Eibl et al.
5582588	Ultrasonic therapeutic apparatus	December, 1996	Sakurai et al.
5588432	Catheters for imaging, sensing electrical potentials, and ablating tissue	December, 1996	Crowley
5590653	Ultrasonic wave medical treatment apparatus suitable for use under guidance of magnetic resonance imaging	January, 1997	Aida et al.
5593394	Shaft for a catheter system	January, 1997	Kanesaka et al.
5599326	Catheter with multi-layer section	February, 1997	Carter
5603445	Ultrasonic wire bonder and transducer improvements	February, 1997	Hill et al.	228/4.5
5607404	Low friction inner lumen	March, 1997	Khairkhahan
5607440	Trocar with lockable shield	March, 1997	Danks et al.
5611807	Ultrasonic angioplasty balloon catheter	March, 1997	O'Boyle
5622170	Apparatus for determining the position and orientation of an invasive portion of a probe inside a three-dimensional body	April, 1997	Schulz
5628743	Dual mode ultrasonic surgical apparatus	May, 1997	Cimino	606/1
5630427	Medical shaft movement control device and method	May, 1997	Hastings
5630797	Everting catheter system and method of utilizing the same	May, 1997	Diedrich et al.
5630837	Acoustic ablation	May, 1997	Crowley	601/2
5647846	Catheter having geometrically shaped surface and method of manufacture	July, 1997	Berg et al.
5651364	Method and apparatus for intravascular	July, 1997	Yock
5651776	Luer-type connector	July, 1997	Appling et al.
5662620	Transport catheter	September, 1997	Lieber et al.
5666970	Locking mechanism for catheters	September, 1997	Smith
5669881	Vascular introducer system incorporating inflatable occlusion balloon	September, 1997	Dunshee
5672172	Surgical instrument with ultrasound pulse generator	September, 1997	Zupkas	606/20
5676011	Precious metal wire drawing apparatus	October, 1997	Allison
5676649	Phacoemulsification cutting tip	October, 1997	Boukhny et al.	604/22
5681296	Catheter tube and a method of processing the inner surface of a tube	October, 1997	Ishida
5685312	Angioplasty apparatus facilitating rapid exchanges and method	November, 1997	Yock
5687474	Method of assembling and cooling a package structure with accessible chip	November, 1997	Hamzehdoost et al.
5688235	Ultrasonic treatment apparatus	November, 1997	Sakurai et al.
5690611	Process for the treatment of atrial arrhythima using a catheter guided by shaped giding introducers	November, 1997	Swartz et al.
5693029	Pro-cell intra-cavity therapeutic agent delivery device	December, 1997	Leonhardt
5704787	Hardened ultrasonic dental surgical tips and process	January, 1998	Hickok et al.
5707359	Expanding trocar assembly	January, 1998	Bufalini
5709120	Straight line drawing device	January, 1998	Shilling
5713363	Ultrasound catheter and method for imaging and hemodynamic monitoring	February, 1998	Seward et al.
5713848	Vibrating catheter	February, 1998	Dubrul et al.	604/22
5715825	Acoustic imaging catheter and the like	February, 1998	Crowley
5720300	High performance wires for use in medical devices and alloys therefor	February, 1998	Fagan et al.
5720710	Remedial ultrasonic wave generating apparatus	February, 1998	Tachibana et al.	601/2
5722627	Mechanism for adjusting the height of a drum chair or the like chair	March, 1998	Hoshino
5725494	Apparatus and methods for ultrasonically enhanced intraluminal therapy	March, 1998	Brisken	604/22
5728062	Apparatus and methods for vibratory intraluminal therapy employing magnetostrictive transducers	March, 1998	Brisken	604/22
5735811	Apparatus and methods for ultrasonically enhanced fluid delivery	April, 1998	Brisken	604/22
5741225	Method for treating the prostate	April, 1998	Lax et al.	604/22
5749889	Method and apparatus for performing biopsy	May, 1998	Bacich et al.
5749914	Catheter for obstructed stent	May, 1998	Janssen
5752932	Intravascular catheter with a recoverable guide wire lumen and method of use	May, 1998	Ellis et al.
5758420	Process of manufacturing an aneurysm clip	June, 1998	Schmidt et al.
5765418	Method for making an implantable medical device from a refractory metal	June, 1998	Rosenberg
5769868	Angioplasty apparatus facilitating rapid exchanges	June, 1998	Yock
5772627	Ultrasonic tissue resector for neurosurgery	June, 1998	Acosta et al.	604/22
5775328	Device for use in temporary insertion of a sensor within a patient's body	July, 1998	Lowe et al.
5776065	Apparatus and method for controlling an ultrasound transducer array	July, 1998	Mehmanpazir et al.
5782861	Percutaneous hemostasis device	July, 1998	Cragg et al.
5797920	Catheter apparatus and method using a shape-memory alloy cuff for creating a bypass graft in-vivo	August, 1998	Kim
5803083	Guiding catheter with ultrasound imaging capability	September, 1998	Buck et al.
5810860	Easily fabricated rotary-drive acoustic ablation catheter	September, 1998	Adrian
5813998	Method and system for coupling acoustic energy using an end-fire array	September, 1998	Dias
5824042	Endoluminal prostheses having position indicating markers	October, 1998	Lombardi et al.
5827203	Ultrasound system and method for myocardial revascularization	October, 1998	Nita	601/2
5827229	Percutaneous aspiration thrombectomy catheter system	October, 1998	Auth et al.
5830125	Catheter introducer with suture capability	November, 1998	Scribner et al.
5830127	Method and apparatus for cleaning endoscopes and the like	November, 1998	DeCastro
5830195	Couplings for medical cannulae	November, 1998	Peters et al.
5833644	Method for emboli containment	November, 1998	Zadno-Azizi et al.
5833650	Catheter apparatus and method for treating occluded vessels	November, 1998	Imran
5836306	Exchange accessory for use with a monorail catheter	November, 1998	Duane et al.
5836896	Method of inhibiting restenosis by applying ultrasonic energy	November, 1998	Rosenschein	601/2
5836897	Ultrasonic treatment apparatus	November, 1998	Sakuri et al.	601/2
5840027	Guiding introducer system for use in the right atrium	November, 1998	Swartz et al.
5840031	Catheters for imaging, sensing electrical potentials and ablating tissue	November, 1998	Crowley
5840151	Apparatus and dies for forming peelable tube assemblies	November, 1998	Munsch
5843017	Multifunctional tissue dissecting instrument	December, 1998	Yoon	604/22
5846218	Balloon catheters having ultrasonically driven interface surfaces and methods for their use	December, 1998	Brisken et al.	604/22
5849009	Flexible probe for high frequency skin treatment	December, 1998	Bernaz
5861023	Thrombus and tissue ingrowth inhibiting overlays for defibrillator shocking coil electrodes	January, 1999	Vachon
5868773	Shielded trocar with safety locking mechanism	February, 1999	Danks et al.
5868778	Vascular sealing apparatus and method	February, 1999	Gershony et al.
5875782	Methods and devices for minimally invasive coronary artery revascularization on a beating heart without cardiopulmonary bypass	March, 1999	Ferrari et al.
5882347	Catheter with internal stiffening ridges	March, 1999	Mouris-Laan et al.
5890406	Electronic torque limiting and parts marking wrench	April, 1999	Thorn
5891149	Apparatus for removal of plastics cement	April, 1999	Young et al.	606/80
5895370	Medical probe (with stylets) device	April, 1999	Edwards et al.	604/22
5895997	Frequency modulated ultrasonic generator	April, 1999	Puskas et al.
5897557	Bone fracture reinforcement structure and method	April, 1999	Chin et al.
5897569	Ultrasonic generator with supervisory control circuitry	April, 1999	Kellogg et al.
5902289	Precurved guiding introducer system for treatment of atrial arrhythmia	May, 1999	Swartz et al.
5904670	Catheters and methods for guiding drugs and other agents to an intended site by deployable grooves	May, 1999	Schreiner
5906628	Ultrasonic treatment instrument	May, 1999	Miyawaki et al.
5908381	Directional surgical device for use with endoscope, gastroscope, colonoscope or the like	June, 1999	Aznoian et al.
5910129	Catheter distal assembly with pull wires	June, 1999	Koblish et al.
5916192	Ultrasonic angioplasty-atherectomy catheter and method of use	June, 1999	Nita et al.
5916210	Catheter for laser treatment of atherosclerotic plaque and other tissue abnormalities	June, 1999	Winston
5919163	Catheter with slidable balloon	July, 1999	Glickman
5919174	Suction valve assembly	July, 1999	Hanson
5920395	System for locating relative positions of objects in three dimensional space	July, 1999	Schulz
5921915	Directional surgical device for use with endoscope, gastroscope, colonoscope or the like	July, 1999	Aznoian et al.
5925016	Systems and methods for drug delivery including treating thrombosis by driving a drug or lytic agent through the thrombus by pressure	July, 1999	Chornenky et al.
5928218	Medical material removal method and associated instrumentation	July, 1999	Gelbfish
5931805	Catheters comprising bending transducers and methods for their use	August, 1999	Brisken	604/22
5935096	Grooved phaco-emulsification needle	August, 1999	Barrett	604/22
5935142	Cavitation-assisted method of material separation	August, 1999	Hood	606/169
5935143	Ultrasonic knife	August, 1999	Hood
5944687	Opto-acoustic transducer for medical applications	August, 1999	Benett et al.
5951480	Ultrasound imaging guidewire with static central core and tip	September, 1999	White et al.
5951539	Optimized high performance multiple coil spiral-wound vascular catheter	September, 1999	Nita et al.
5951583	Thrombin and collagen procoagulant and process for making the same	September, 1999	Jensen et al.
5957882	Ultrasound devices for ablating and removing obstructive matter from anatomical passageways and blood vessels	September, 1999	Nita et al.	604/22
5961444	In vitro fertilization procedure using direct vision	October, 1999	Thompson
5964756	Transurethral needle ablation device with replaceable stylet cartridge	October, 1999	McGaffigan et al.	606/41
5971949	Ultrasound transmission apparatus and method of using same	October, 1999	Levin et al.
5971960	Trocar with expandable members for retaining the trocar	October, 1999	Flom et al.
5971983	Tissue ablation device and method of use	October, 1999	Lesh
5974884	Ultrasonic diagnostic apparatus and ultrasonic probe with acoustic matching layer having continuously varied acoustic impedance in the thickness direction	November, 1999	Sano et al.
5976093	Vascular catheter having low-profile distal end	November, 1999	Jang
5980563	Ablation apparatus and methods for treating atherosclerosis	November, 1999	Tu et al.
5981444	Process for manufacturing a superconducting wire of compound oxide-type ceramics	November, 1999	Sawada et al.
5984882	Methods for prevention and treatment of cancer and other proliferative diseases with ultrasonic energy	November, 1999	Rosenschein et al.
5984950	Percutaneous hemostasis device	November, 1999	Cragg et al.
5987349	Method for determining the position and orientation of two moveable objects in three-dimensional space	November, 1999	Schulz
5989208	Therapeutic ultrasound system	November, 1999	Nita	604/22
5989209	Grooved phaco-emulsification needle	November, 1999	Barrett	604/22
5989274	Methods and devices for improving blood flow to a heart of a patient	November, 1999	Davison et al.	606/169
5989280	Stent delivery apparatus and method	November, 1999	Euteneuer et al.	623/1.1
5993408	Thin tip phaco needle	November, 1999	Zaleski
5997497	Ultrasound catheter having integrated drug delivery system and methods of using same	December, 1999	Nita et al.	604/22
5997523	Vascular catheter having low-profile distal end	December, 1999	Jang
6001355	Pro-tPA for the treatment of thrombosis, embolism and related conditions	December, 1999	Dowdle
6004269	Catheters for imaging, sensing electrical potentials, and ablating tissue	December, 1999	Crowley et al.
6007514	Ultrasound system with pathfinding guidewire	December, 1999	Nita
6010476	Apparatus for performing transmyocardial revascularization	January, 2000	Saadat
6010498	Endovascular electrolytically detachable wire and tip for the formation of thrombus in arteries, veins, aneurysms, vascular malformations and arteriovenous fistulas	January, 2000	Guglielmi
6017340	Pre-curved wire guided papillotome having a shape memory tip for controlled bending and orientation	January, 2000	Cassidy et al.
6017354	Integrated system for powered surgical tools	January, 2000	Culp et al.
6017359	Vascular sealing apparatus	January, 2000	Gershony et al.
6019777	Catheter and method for a stent delivery system	February, 2000	Mackenzie
6021694	Surgical torque wrench	February, 2000	Beger
6022336	Catheter system for emboli containment	February, 2000	Zadno-Azizi et al.
6022369	Wire device with detachable end	February, 2000	Jacobsen et al.
6024718	Intraluminal directed ultrasound delivery device	February, 2000	Chen et al.	604/22
6027515	Pulsed ultrasonic device and method	February, 2000	Cimino
6032078	Voltage controlled variable tuning antenna	February, 2000	Rudie	607/101
6033375	Ultrasonic probe with isolated and teflon coated outer cannula	March, 2000	Brumbach	604/22
6033411	Precision depth guided instruments for use in vertebroplasty	March, 2000	Preissman
6036648	Machine tilt transducer and methods of making	March, 2000	White et al.	600/459
6036671	Breakaway syringe and disposal apparatus	March, 2000	Frey
6036697	Balloon catheter with balloon inflation at distal end of balloon	March, 2000	DiCaprio
6036715	Angioplasty apparatus facilitating rapid exchanges	March, 2000	Yock
6039693	Volumetric image ultrasound transducer underfluid catheter system	March, 2000	Seward et al.
6039762	Reinforced bone graft substitutes	March, 2000	McKay
6045527	Detection of ophthalmic surgical handpiece using shorting bar	April, 2000	Appelbaum et al.
6048329	Catheter distal assembly with pull wires	April, 2000	Thompson et al.
6050949	Catheher system having connectable distal and proximal portions	April, 2000	White et al.
6051772	Method and apparatus for emulating a frequency modulation device	April, 2000	Cameron et al.
6053904	Thin wall catheter introducer system	April, 2000	Scribner et al.
RE36693	Container and method for transporting a syringe containing radioactive material	May, 2000	Reich
6056722	Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and methods of use	May, 2000	Jayaraman
6057798	Apparatus and method for frequency modulation	May, 2000	Burrier et al.
6059789	Drill guide for creating a tunnel in bone for fixating soft tissue to the bone and kit and method for fixating soft tissue to bone	May, 2000	Dinger et al.
6062001	Sharps disposal container	May, 2000	Kunik
6062059	Manufacture of extrusion dies	May, 2000	Feldcamp
6068610	Intravascular catheter with a recoverable guide wire lumen and method of use	May, 2000	Ellis et al.
6077285	Torsional ultrasound handpiece	June, 2000	Boukhny	606/169
6083191	Ultrasonic surgical apparatus	July, 2000	Rose
6083501	Drug for prevention and therapy of diseases caused by fibrinoid formation or thrombus formation in the lung and model animals of the diseases	July, 2000	Miyata et al.
6090118	Rotational thrombectomy apparatus and method with standing wave	July, 2000	McGuckin, Jr.
6099464	Bending sheath for probe	August, 2000	Shimizu et al.
6106475	Device for use in temporary insertion of a sensor within a patient's body	August, 2000	Lowe et al.
6106538	Method for forming an internal coronary bypass	August, 2000	Shiber
6107161	Semiconductor chip and a method for manufacturing thereof	August, 2000	Kitaguro et al.
6110142	Balloons for medical devices and fabrication thereof	August, 2000	Pinchuk et al.
6110176	Methods for extracting bone marrow	August, 2000	Shapira
6113558	Pulsed mode lysis method	September, 2000	Rosenschein et al.
6113570	Method of removing thrombosis in fistulae	September, 2000	Siegel et al.
6113580	Cervical barrier shield for female vaginal douche	September, 2000	Dolisi
6123718	Balloon catheter	September, 2000	Tu et al.
6124150	Transverse hybrid LOC package	September, 2000	Corisis
6124546	Integrated circuit chip package and method of making the same	September, 2000	Hayward et al.
6124634	Micromachined chip scale package	September, 2000	Akram et al.
6129672	Volumetric image ultrasound transducer underfluid catheter system	October, 2000	Seward et al.
6146380	Bent tip electrical surgical probe	November, 2000	Racz et al.
6146381	Catheter having distal region for deflecting axial forces	November, 2000	Bowe et al.
6156018	Guiding introducer system for use in medical procedures in the left ventricle	December, 2000	Hassett
6159195	Exchange catheter and method of use	December, 2000	Ha et al.
6162053	Analog dental wrench	December, 2000	Hollander
6165197	Angioplasty apparatus facilitating rapid exchanges	December, 2000	Yock
6190353	Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures	February, 2001	Makower et al.
6193683	Closed loop temperature controlled phacoemulsification system to prevent corneal burns	February, 2001	Ludin et al.
6200269	Forward-scanning ultrasound catheter probe	March, 2001	Lin et al.
6200315	Left atrium ablation catheter	March, 2001	Gaiser et al.
6203516	Phacoemulsification device and method for using dual loop frequency and power control	March, 2001	Kepley
6203568	Endoluminal prostheses having position indicating markers	March, 2001	Lombardi et al.
6224565	Protective sheath and method for ultrasonic probes	May, 2001	Cimino	604/22
6228046	Catheters comprising a plurality of oscillators and methods for their use	May, 2001	Brisken	604/22
6231514	Device for use in temporary insertion of a sensor within a patient's body	May, 2001	Lowe et al.
6231518	Intrapericardial electrophysiological procedures	May, 2001	Grabek et al.
6234971	Vascular catheter having low-profile distal end	May, 2001	Jang
6235000	Apparatus for crossing total occlusion in blood vessels	May, 2001	Milo et al.
6241703	Ultrasound transmission apparatus having a tip	June, 2001	Levin et al.
6245095	Method and apparatus for location and temperature specific drug action such as thrombolysis	June, 2001	Dobak, III et al.
6247592	System for disposal of contaminated medical products	June, 2001	Racicot et al.
6258798	Method for treatment of unstable coronary artery disease by an early revascularisation together with administration of a low molecular weight heparin	July, 2001	Wallentin
6262062	Method of treating the syndrome of coronary heart disease risk factors in humans	July, 2001	Clemens
6270460	Apparatus and method to limit the life span of a diagnostic medical ultrasound probe	August, 2001	McCartan et al.
6277084	Ultrasonic medical device	August, 2001	Abele et al.
6279743	Device for facilitating engagement and disengagement between needles and associated syringes and sheaths and for receiving sharps	August, 2001	Ballard et al.
6280413	Thrombolytic filtration and drug delivery catheter with a self-expanding portion	August, 2001	Clark et al.
6283951	Systems and methods for delivering drugs to selected locations within the body	September, 2001	Flaherty et al.
6287271	Motion catheter	September, 2001	Dubrul et al.	604/22
6287272	Balloon catheters having ultrasonically driven interface surfaces and methods for their use	September, 2001	Brisken et al.
6290662	Portable, self-contained apparatus for deep vein thrombosis (DVT) prophylaxis	September, 2001	Morris et al.
6290673	Expandable medical device delivery system and method	September, 2001	Shanley
6293725	Collet and method	September, 2001	Winkvist
6296658	Vascular sealing apparatus	October, 2001	Gershony et al.
6303635	Thrombolytic drug	October, 2001	Kawai et al.
6306097	Ultrasound imaging catheter guiding assembly with catheter working port	October, 2001	Park et al.
6307156	High flexibility and heat dissipating coaxial cable	October, 2001	Avellanet
6309379	Sheath for selective delivery of multiple intravascular devices and methods of use thereof	October, 2001	Willard et al.
6312406	Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and method of use	November, 2001	Jayaraman
6322541	Vascular introducer sheath and hemostasis valve for use therewith	November, 2001	West et al.
6329778	Integrated system for powered surgical tools	December, 2001	Culp et al.
6346091	Detachable coil for aneurysm therapy	February, 2002	Jacobsen et al.
6348039	Rectal temperature sensing probe	February, 2002	Flachman et al.
6358252	Apparatus for extracting bone marrow	March, 2002	Shapira
6364840	Acoustic imaging catheter and the like	April, 2002	Crowley	600/463
6364841	System and method for intraluminal imaging	April, 2002	White et al.
6368611	Anti-infective covering for percutaneous and vascular access device and coating method	April, 2002	Whitbourne et al.
6376513	Drug for relieving pain and promoting the removal of calculi in urolithiasis	April, 2002	Akahane et al.
6383151	Circumferential ablation device assembly	May, 2002	Diederich et al.
6391042	Pulsed ultrasonic device and method	May, 2002	Cimino
6396293	Self-closing spring probe	May, 2002	Vinther et al.
6398776	Tubular medical device	June, 2002	Sekino et al.
6398792	Angioplasty catheter with transducer using balloon for focusing of ultrasonic energy and method for use	June, 2002	O'Connor
6410560	Drug for relieving pain and promoting the removal of calculi in urolithiasis	June, 2002	Akahane et al.
6416511	Circumferential ablation device assembly	July, 2002	Lesh et al.
6416530	Device and method for selectively removing a thrombus filter	July, 2002	DeVries et al.
6416737	Increasing bone strength with selected bisphosphonates	July, 2002	Manolagas et al.
6419644	System and method for intraluminal imaging	July, 2002	White et al.
6433464	Apparatus for selectively dissolving and removing material using ultra-high frequency ultrasound	August, 2002	Jones
6440726	Expression vectors comprising multiple shear stress responsive elements (SSRE) and methods of use for treating disorders related to vasculogenesis and/or angiogenesis in a shear stress environment	August, 2002	Resnick
6440947	Method for treating occlusive peripheral vascular disease and coronary disease	August, 2002	Barron et al.
6443903	System and method for intraluminal imaging	September, 2002	White et al.
6450975	Ultrasonic transmission guide wire	September, 2002	Brennan et al.
6451303	Method of treating coronary artery disease by administering a recombinant FGF	September, 2002	Whitehouse et al.
6454737	Ultrasonic angioplasty-atherectomy catheter and method of use	September, 2002	Nita et al.
6454757	Ultrasonic method for ablating and removing obstructive matter from anatomical passageways and blood vessels	September, 2002	Nita et al.
6457365	Method and apparatus for ultrasonic imaging	October, 2002	Stephens et al.
6458375	Malleable paste with allograft bone reinforcement for filling bone defects	October, 2002	Gertzman et al.
6462172	Purification of tissue plasminogen activator (TPA)	October, 2002	Maclennan et al.
6464660	Balloon catheters having ultrasonically driven interface surfaces and methods for their use	October, 2002	Brisken et al.
6469419	Ultrasonic motor capable of sensing both longitudinal and torsional vibrations thereof and method for operating the same	October, 2002	Kato et al.
6471656	Method and system for pressure based measurements of CFR and additional clinical hemodynamic parameters	October, 2002	Shalman et al.
6475185	Occlusion device	November, 2002	Rauker et al.
6478751	Bone marrow aspiration needle	November, 2002	Krueger et al.
6482218	Wire-shaped ultrasonic catheter with diamond coated head for ultrasonic angioplasty	November, 2002	Tran
6485481	Catheter system	November, 2002	Pfeiffer
6491710	Balloon catheter for pulmonary vein isolation	December, 2002	Satake
6491711	Balloon catheter with non-circular balloon taper and method of use	December, 2002	Durcan
6494883	Bone reinforcers	December, 2002	Ferree
6494885	Endoscopic stone extraction device with rotatable basket	December, 2002	Dhindsa
6494891	Ultrasonic angioplasty transmission member	December, 2002	Cornish et al.
6494893	Trocar system having expandable port	December, 2002	Dubrul et al.
6497667	Ultrasonic probe using ribbon cable attachment system	December, 2002	Miller et al.
6497698	Method and apparatus for treating a patient	December, 2002	Fonger et al.
6503223	Balloon catheter	January, 2003	Sekido et al.
6508781	Ultrasonic ablation catheter transmission wire connector assembly	January, 2003	Brennan et al.
6508782	Thrombolysis device	January, 2003	Evans et al.
6509348	Combination of an ADP-receptor blocking antiplatelet drug and a thromboxane A2 receptor antagonist and a method for inhibiting thrombus formation employing such combination	January, 2003	Ogletree
6511492	Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders	January, 2003	Rosenbluth et al.
6512957	Catheter having a guide sleeve for displacing a pre-bent guidewire	January, 2003	Witte
6514210	Forward viewing and radial scanning ultrasonic endoscope	February, 2003	Ohara et al.
6522929	Treatment of peripheral vascular disease, leg cramps and injuries using needles and electrical stimulation	February, 2003	Swing
6524251	Ultrasonic device for tissue ablation and sheath for use therewith	February, 2003	Rabiner et al.	600/439
6527115	Dispensation and disposal container for medical devices	March, 2003	Rabiner et al.
6530923	Tissue removal methods and apparatus	March, 2003	Dubrul et al.
6544276	Exchange method for emboli containment	April, 2003	Azizi
6544279	Vascular device for emboli, thrombus and foreign body removal and methods of use	April, 2003	Hopkins et al.
6544541	Devices and compounds for treating arterial restenosis	April, 2003	Zahradka
6547724	Flexible sleeve slidingly transformable into a large suction sleeve	April, 2003	Soble et al.
6547754	Thrombolysis device	April, 2003	Evans et al.
6551269	Introducer catheter lead delivery device with collapsible stylet lumen	April, 2003	Clemens et al.
6551327	Endoscopic stone extraction device with improved basket	April, 2003	Dhindsa
6551337	Ultrasonic medical device operating in a transverse mode	April, 2003	Rabiner et al.
6558334	Apparatus for diagnosing lesion severity, and method therefor	May, 2003	Shalman et al.
6569109	Ultrasonic operation apparatus for performing follow-up control of resonance frequency drive of ultrasonic oscillator by digital PLL system using DDS (direct digital synthesizer)	May, 2003	Sakurai et al.
6569148	Methods for emboli containment	May, 2003	Bagaoisan et al.
6572555	System and method for intraluminal imaging	June, 2003	White et al.
6575959	Catheter incorporating an insert molded hub and method of manufacturing	June, 2003	Sarge et al.
6575993	Angioplasty apparatus facilitating rapid exchanges	June, 2003	Yock
6577042	Feedback control system for ultrasound probe	June, 2003	Lee et al.
6579277	Variable stiffness medical device	June, 2003	Rabiner et al.
6579279	Steerable catheter device	June, 2003	Rabiner et al.
6579302	Total occlusion guidewire device	June, 2003	Duerig et al.
6585657	Angioplasty apparatus facilitating rapid exchanges	July, 2003	Yock
6589253	Ultrasonic angioplasty transmission wire	July, 2003	Cornish et al.
6592548	Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and method of use	July, 2003	Jayaraman
6596020	Method of delivering a stent with a side opening	July, 2003	Vardi et al.
6605074	Method for containing and removing occlusions in the carotid arteries	August, 2003	Zadno-Azizi et al.
6611793	Systems and methods to identify and disable re-use single use devices based on detecting environmental changes	August, 2003	Burnside et al.
6615080	Neuromuscular electrical stimulation of the foot muscles for prevention of deep vein thrombosis and pulmonary embolism	September, 2003	Unsworth et al.
6617760	Ultrasonic resonator	September, 2003	Peterson et al.
6620113	System for intraluminal imaging	September, 2003	White et al.
6626853	System for intraluminal imaging	September, 2003	White et al.
6626926	Method for driving an ultrasonic system to improve acquisition of blade resonance frequency at startup	September, 2003	Friedman et al.
6629948	Rapid pulse phaco power for burn free surgery	October, 2003	Rockley et al.
6645149	Ultrasound devices	November, 2003	Smith
6645152	Apparatus for the intravascular ultrasound-guided placement of a vena cava filter	November, 2003	Jung et al.
6647755	Method for manufacturing small diameter medical devices	November, 2003	Rabiner et al.
6648881	Method for reducing arterial restenosis in the presence of an intravascular stent	November, 2003	KenKnight et al.
6652547	Apparatus and method of removing occlusions using ultrasonic medical device operating in a transverse mode	November, 2003	Rabiner et al.	606/159
6655386	Transluminal method for bypassing arterial obstructions	December, 2003	Makower et al.
6660013	Apparatus for removing plaque from blood vessels using ultrasonic energy	December, 2003	Rabiner et al.
6669665	Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and method of use	December, 2003	Jayaraman
6679873	Method for using a steerable catheter device	January, 2004	Rabiner et al.
6682556	Application catheter and method of implantation of a stent in vascular bifurcations, side branches and ostial lesions	January, 2004	Ischinger
6689086	Method of using a catheter for delivery of ultrasonic energy and medicament	February, 2004	Nita et al.
6689087	Floating probe for ultrasonic transducers	February, 2004	Pal et al.
6692460	Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and method of use	February, 2004	Jayaraman
6695781	Ultrasonic medical device for tissue remodeling	February, 2004	Rabiner et al.
6695782	Ultrasonic probe device with rapid attachment and detachment means	February, 2004	Ranucci et al.
6702748	Connector for securing ultrasound catheter to transducer	March, 2004	Nita et al.
6702750	Angioplasty apparatus facilitating rapid exchanges and methods	March, 2004	Yock
6712766	Ultrasonic probe	March, 2004	Harada
6726698	Pulsed ultrasonic device and method	April, 2004	Cimino
D489973	Medical device package	May, 2004	Root et al.
6730037	Vascular catheter having low-profile distal end	May, 2004	Jang
6730048	Apparatus and method for ultrasonic medical device with improved visibility in imaging procedures	May, 2004	Hare et al.
6733451	Apparatus and method for an ultrasonic probe used with a pharmacological agent	May, 2004	Rabiner et al.
6760165	System and method for manufacturing an assembly including a housing and a window member therein	July, 2004	Wulff et al.
6761690	Ultrasonic operation apparatus for performing follow-up control of resonance frequency drive of ultrasonic oscillator by digital PLL system using DDS (direct digital synthesizer)	July, 2004	Sakurai et al.
6790204	Method for containing and removing occlusions in the carotid arteries	September, 2004	Zadno-Azizi et al.
6802835	Apparatus and method for using a steerable catheter device	October, 2004	Rabiner et al.
6840952	Tissue tract sealing device	January, 2005	Saker et al.
6849062	Catheter having a low-friction guidewire lumen and method of manufacture	February, 2005	Kantor
6855123	Therapeutic ultrasound system	February, 2005	Nita
6855125	Expandable medical device delivery system and method	February, 2005	Shanley
6860876	Versatile interventional coronary guiding catheter	March, 2005	Chen
6866670	Apparatus for removing plaque from blood vessels using ultrasonic energy	March, 2005	Rabiner et al.
6878106	Deformable fiberscope with a displaceable supplementary device	April, 2005	Herrmann
6887257	Vascular embolic filter exchange devices and methods of use thereof	May, 2005	Salahieh et al.
6908472	Apparatus and method for altering generator functions in an ultrasonic surgical system	June, 2005	Wiener et al.
6921411	Angioplasty apparatus facilitating rapid exchanges and method	July, 2005	Yock
6923788	Catheter having a low-friction guidewire lumen and method of manufacture	August, 2005	Kantor
6929632	Ultrasonic devices and methods for ablating and removing obstructive matter from anatomical passageways and blood vessels	August, 2005	Nita et al.
6939317	Repetitive progressive axial displacement pattern for phacoemulsifier needle tip	September, 2005	Zacharias
6942620	Connector for securing ultrasound catheter to transducer	September, 2005	Nita et al.
6942677	Ultrasound catheter apparatus	September, 2005	Nita et al.
6966891	Catheter	November, 2005	Ookubo et al.
6984220	Longitudinal-torsional ultrasonic tissue dissection	January, 2006	Wuchinich
20010047166	Longitudinal-torsional ultrasonic tissue Dissection	November, 2001	Wuchinich
20020007130	METHODS AND APPARATUS FOR SECURING MEDICAL INSTRUMENTS TO DESIRED LOCATIONS IN A PATIENTS BODY	January, 2002	Burbank et al.
20020016565	CATHETER SYSTEM FOR EMBOLI CONTAINMENT	February, 2002	Zadno-Azizi et al.
20020029014	Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and method of use	March, 2002	Jayaraman
20020029054	Ultrasonic medical device for tissue remodeling	March, 2002	Rabiner et al.
20020055754	Utrasonic probe device with rapid attachment and detachment means	May, 2002	Ranucci et al.
20020077550	Apparatus and method for treating gynecological diseases using an ultrasonic medical device operating in a transverse mode	June, 2002	Rabiner et al.
20020077643	Method of removing occlusions using ultrasonic medical device operating in a transverse mode	June, 2002	Rabiner et al.
20020082503	RF ablation and ultrasound catheter for crossing chronic total occlusions	June, 2002	Chandrasekaran et al.
20020091407	Catheter system for emboli containment	July, 2002	Zadno-Azizi et al.
20020095141	Rapid exchange sheath for deployment of medical devices and methods of use	July, 2002	Belef et al.
20020107446	Ultrasonic device for tissue ablation and sheath for use therewith	August, 2002	Rabiner et al.
20030009125	Ultrasonic devices and methods for ablating and removing obstructive matter from anatomical passageways and blood vessels	January, 2003	Nita et al.
20030045835	Method and apparatus for coagulation and closure of pseudoaneurysms	March, 2003	Anderson et al.
20030045887	Ultrasonic calculus treatment apparatus	March, 2003	Sakurai et al.
20030048037	Thickness mode piezoelectric transducer with resonant drive circuit	March, 2003	Boyd
20030074006	Medical device with enhanced guide capabilities	April, 2003	Mowry et al.
20030114732	Sheath for guiding imaging instruments	June, 2003	Webler et al.
20030120208	Rapid exchange catheter with stent deployment, therapeutic infusion, and lesion sampling features	June, 2003	Houser et al.
20030125751	Catheter	July, 2003	Griffin et al.
20030176791	Ultrasonic device for tissue ablation and sheath for use therewith	September, 2003	Rabiner et al.
20030181923	Methods for deploying stents in bifurcations	September, 2003	Vardi
20030197958	System and method for manufacturing an assembly including a housing and a window member therein	October, 2003	Wulff et al.
20030212331	Ultrasonic soft tissue cutting and coagulation systems having multiple superposed vibrational modes	November, 2003	Fenton et al.
20030225332	Ultrasonic therapeutic apparatus	December, 2003	Okada et al.
20030236539	Apparatus and method for using an ultrasonic probe to clear a vascular access device	December, 2003	Rabiner et al.
20040019266	Apparatus and method for radiopaque coating for an ultrasonic medical device	January, 2004	Marciante et al.
20040024393	Therapeutic ultrasound system	February, 2004	Nita et al.
20040024402	Therapeutic ultrasound system	February, 2004	Nita
20040039311	Ultrasound catheter for disrupting blood vessel obstructions	February, 2004	Nita et al.
20040039375	Ultrasonic operating apparatus	February, 2004	Miyazawa
20040059227	Connector for securing ultrasound catheter to transducer	March, 2004	Nita et al.
20040059280	Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures	March, 2004	Makower et al.
20040068189	Ultrasound catheter with embedded conductors	April, 2004	Wilson et al.
20040097996	Apparatus and method of removing occlusions using an ultrasonic medical device operating in a transverse mode	May, 2004	Rabiner et al.
20040106866	Catheter	June, 2004	Ookubo et al.
20040119287	Ferrule With Relief To Reduce Galling	June, 2004	Williams et al.
20040138570	Ultrasound catheter and methods for making and using same	July, 2004	Nita et al.
20040167507	Ultrasound catheter apparatus	August, 2004	Nita et al.
20040199228	Ultrasonic catheter with axial energy field	October, 2004	Wilson
20040204670	Ultrasound catheter devices and methods	October, 2004	Nita et al.
20040204729	Pulsed ultrasonic device and method	October, 2004	Cimino
20040210140	Apparatus and method for preshaped ultrasonic probe	October, 2004	Rabiner et al.
20040213866	System and method for manufacturing an assembly including a housing and a window member therein	October, 2004	Wulff et al.
20040243052	Vascular access closure system	December, 2004	Kauphusman et al.
20050043629	Apparatus and method for an ultrasonic medical device having a probe with a small proximal end	February, 2005	Rabiner et al.
20050059991	Expandable medical device delivery system and method	March, 2005	Shanley
20050070794	System for introducing multiple medical devices	March, 2005	Deal et al.
20050101870	Catheter	May, 2005	Yamaguchi et al.
20050101906	Therapeutic ultrasound system	May, 2005	Nita
20050113688	Steerable ultrasound catheter	May, 2005	Nita et al.
20050119606	Therapeutic ultrasound system	June, 2005	Nita
20050124877	Device and method for supporting placement of a therapeutic device in a blood vessel	June, 2005	Nita et al.
20050171570	Angioplasty apparatus facilitating rapid exchanges and method	August, 2005	Yock
20050209677	Stent delivery devices	September, 2005	Shaked
20050240165	Suction catheter	October, 2005	Miki et al.
20050245951	Ultrasound catheter apparatus	November, 2005	Nita et al.
20050277577	Compositions and methods for treating diverticular disease	December, 2005	Hunter et al.
20050283080	Connector for securing ultrasound catheter to transducer	December, 2005	Nita et al.

CA2251096	August, 1998
CA2320300	August, 1999
CA2362689	September, 2000
DE428980	May, 1926
DE203229	October, 1983
DE3731482	April, 1988
EP0121491	October, 1984			Implant.
EP0243298	October, 1987			Construction kit for a stem prosthesis.
EP0293472	December, 1988			ULTRASONIC SURGICAL APPARATUS.
EP0316796	May, 1989			Intravascular ultrasonic catheter probe for treating intravascular blockage
EP0353294	February, 1990			SYSTEM FOR ANGIOPLASTY AND ULTRASONIC CONTRAST IMAGING.
EP0493047	July, 1992			Tensioner with damping system
EP0541249	May, 1993			Ultrasonic handpiece.
EP0542103	May, 1993			Tissue gripping device.
EP0891744	January, 1999			Ultrasonic transmission apparatus
FR461395	December, 1913
FR2614524	November, 1988
GB19559	September, 1899
GB1371335	October, 1974
GB2032221	April, 1980
GB2325192	November, 1998
JP62224339	March, 1986
JP64027548	January, 1989
JP02092348	April, 1990			ULTRASONIC PROBE
WO/1987/001276	March, 1987			ENDOSCOPIC ULTRASONIC ASPIRATOR WITH MODIFIED WORKING TIP
WO/1989/006515	July, 1989			SYSTEM FOR ANGIOPLASTY AND ULTRASONIC CONTRAST IMAGING
WO/1990/001300	February, 1990			ULTRASONIC DEVICE FOR APPLYING CAVITATION FORCES
WO/1990/010423	September, 1990			DEVICE FOR REMOVING A BONE CEMENT TUBE
WO/1991/007138	May, 1991			METHOD AND APPARATUS FOR REMOVAL OF CEMENT FROM BONE CAVITIES
WO/1992/004071	March, 1992			PROBE DESIGNED TO BE INSERTED IN CAVITIES IN THE HUMAN BODY
WO/1992/011815	July, 1992			ULTRASONIC ANGIOPLASTY DEVICE INCORPORATING TRANSMISSION MEMBER AND ABLATION PROBE
WO/1993/016646	September, 1993			ULTRASONIC TRANSMISSION APPARATUS
WO/1995/003740	February, 1995			LIPOSUCTION APPARATUS AND ASSOCIATED METHOD
WO/1996/007377	March, 1996			GROOVED PHACO-EMULSIFICATION NEEDLE
WO/1998/035721	August, 1998			ULTRASOUND TRANSMISSION APPARATUS AND METHOD OF USING SAME
WO/1998/055032	December, 1998			CATHETERS COMPRISING BENDING TRANSDUCERS AND METHODS FOR THEIR USE
WO/1999/016360	April, 1999			LYSIS METHOD AND APPARATUS
WO/1999/033404	July, 1999			TIPS FOR ULTRASONIC HANDPIECE
WO/1999/035982	July, 1999			ULTRASONIC CUTTING TOOL
WO/1999/039647	August, 1999			APPARATUS AND METHOD FOR INHIBITING RESTENOSIS BY APPLYING ULTRASOUND ENERGY TOGETHER WITH DRUGS
WO/2000/021444	April, 2000			ULTRASONIC PROBE AND METHOD FOR IMPROVED FRAGMENTATION
WO/2000/053263	September, 2000			DUAL TRANSDUCER ULTRASOUND LYSIS METHOD AND APPARATUS

PCT International Search Report for International Application No. PCT/US02/22517 dated Oct. 18, 2002.
PCT International Search Report for International Application No. PCT/US03/09099 dated Mar. 2, 2004.
BBI Newsletter, vol. XIII, No. 3, p. 44, Biomedical Business International, 1524 Brookhollow Drive, Santa Ana, California 92705 (1990).
Beckenbaugh, R.D. and M.S. Ilstrup, Total Hip Arthroplasty, J. Bone and Joint Surgery, vol. 60A, pp. 308-314 (1978).
Brochure, Endo-Urology—A Breakthrough in Ultrasonic Lithotripsy, Karl Storz Endoscopy—America, Inc. (1984).
Brochure, Instruments and Apparatus for Lithotripsy, Richard Wolf GmbH, Knittlinger, West Germany (1984).
Brochure, Percutaneous Low Pressure Universal Nephroscope, Richard Wolf, Knittlinger, West Germany (1984).
Cameron, Proximal Femoral Osteotomy in Difficult Revision Hip Surgery: How to Revise the Unrevisable, 18 Contemp. Orthopaedics 565 (1989).
Caspar, Current Development of Instrumentation for Arthroscopy, Clinics in Sports Medicine, 6:3 (1987), pp. 626-627.
Chaussy et al., “Transurethral Ultrasonic Ureterolithotripsy Using a Solid-Wire Probe,” Urology, 29(5):531-532 (May 1987).
De Puy Inc., Catalog (1966).
Eisner, Physical Acoustics, 1964, pp. 353-363.
Emsinger, Ultrasonics, 1988, pp. 419-492.
Ensminger, Ultrasonics: Fundamentals, Technology, Applications, pp. 462-467, Marcel Dekker Inc. (1988).
Epstein et al., Surgical Management of Extensive Intramedullary Spinal Cord Astrocytoma in Children, Concepts in Pediatric Neurosurgery, 2, (1982) pp. 29-44.
Goliamina, “Ultrasonic Surgery”, Proceedings of the Eighth Int'l. Cong. On Acoustics, London, 1974, pp. 63-69.
Gray, “Endovascular treatment of peripheral arterial disease,” Journal of the American Osteopathic Association, 100(10):S15-S20 (Supplement to Oct. 2000).
Harris et al., A New Technique for Removal of Broken Femoral Stems in Total Hip Replacement, 63-A J. Bone & Joint Surgery 843 (1981).
Johnson, Arthroscopic Surgery: Principles and Practice (3rd Edition), Verlag Springer (1986), pp. 244-245.
Karpman et al., The Lithotriptor and Its Potential Use in the Revision of Total Hip Arthroplasty, 16 Orthopaedic Rev. 81 (1987).
Klapper and Caillouette, “The Use of Ultrasonic Tools in Revision Arthoplasty Procedures”, 20:3 Contemporary Orthopaedics, pp. 273-279 (Mar. 1990).
Krawitt et al., Ultrasonic Aspiration of Prostate, Bladder Tumors and Stones, Urology, 30:6 (1987) pp. 578-580.
Lin, Posterior Lumbar Interbody Fusion Technique: Complications and Pitfalls, 193 Clinical Orthopaedics and Related Research 90 (1985).
Malloy et al., Endoscopis Ultrasonic Aspiration of the Prostate, Bladder Tumors and Stones, Journal of Urology Supplement, May 1989.
Malloy et al., Transurethral Ultrasonic Aspiration of the Prostrate, A.U.A., May 1989.
McClelland et al., Atraumatic Removal of a Well-Fixed Porous Ingrowth Hip Prosthesis, 15 Orthopaedic Rev. 75 (1986).
Moreland et al., Techniques for Removal of Prosthesis and Cement in Total Hip Revisional Surgery, Contemporary Orthopaedics, V. 21, No. 6, pp. 595-635, 1990.
Moreland et al., The Window Technique for the Removal of Broken Femoral Stems in Total Hip Replacement, 212 Clinical Orthopaedics and Related Research 245 (1986).
Neppiras, The Pre-Stressed Piezoelectric Sandwich Transducer, 1973, pp. 295-302.
Rayleigh, The Theory of Sound, vol. 1, 1894, pp. 255-305.
Richards Mfg. Co., Orthopedic Catalog (1981).
Richmond et al., Evaluation of the Histopathology of Brain Tumor Tisue Obtained by Ultrasonic Aspiration, Neurosurgery, 13:4 (1983), pp. 415-419.
Rozenberg, Sources of High-Intensity Ultrasound, vol. 2, 1973, pp. 111-114.
Sahagian, Richard, “Critical Insight: Marking Devices with Radiopaque Coatings,” May 1999, Medical Device & Diagnostic Industry Magazine (http://www.devicelink.com/mddi/archive/99/05/011.html).
Schwartz, Jr. et al., Femoral Fracture During Non-Cemented Total Hip Arthroplasty, 71-A J. Bone & Joint Surgery 1135 (1989).
Sternlieb et al., Ultrasonic Restoration of Severely Calcified Aortic Valve, The Lancet, Aug. 20, 1988, p. 446.
Weis, Jr., A Sonic Tool for Spinal Fusion, 8 Orthopedic Clinics of North Am. 43 (1977).
Wick et al., “Tool and Manufacturing Engineers Handbood,” Fourth Edition, vol. II, Forming, Society of Manufacturing Engineers, Dearbord, Michigan, 1983-1984, pp. 13-1 through 13-2 (spelling error?).
Zhou et al., Effect of Press-Fit Femoral Stems on Strains in the Femur, 5 J. Arthroplasty 71 (1990).

Winakur, Eric F.

Cheng, Jacqueline

Fish & Richardson P.C.

We claim:

1. An ultrasonic medical device for tissue ablation comprising: an elongated probe having a proximal end, a distal end and at least two regions of differing cross sectional dimension, wherein a length of the elongated probe is configured to oscillate in a direction transverse to a longitudinal axis of the elongated probe to emit transverse ultrasonic energy along the length of the elongated probe so that a plurality of transverse nodes and transverse anti-nodes are formed along the length of the elongated probe; and a sheath assembly at least partially surrounding the elongated probe, the sheath assembly comprising at least one sheath defining a fenestration between a proximal and distal end of the at least one sheath, the at least one sheath being configured to substantially dampen ultrasonic energy such that ultrasonic energy delivered by the elongated probe is focused toward a region adjacent the fenestration.

2. The device of claim 1, wherein the sheath assembly covers at least a portion of the elongated probe, the sheath assembly comprising a longitudinally extending structural wall that defines a longitudinally extending hollow interior for accommodating at least a portion of the elongated probe, wherein the longitudinally extending structural wall of the sheath assembly is substantially self supporting so that the longitudinally extending structural wall substantially maintains a same shape with the elongated probe disposed in the longitudinally extending hollow interior as without the elongated probe disposed in the longitudinally extending hollow interior.

3. The device of claim 1, wherein the sheath assembly is constructed to substantially prevent a transmission of cavitational energy generated by the elongated probe to a surrounding environment.

4. The device of claim 1, wherein the sheath assembly further comprises one or more devices capable of manipulating a tissue.

5. The device of claim 1, wherein the sheath assembly further comprises at least one reflective element configured to reflect ultrasonic energy.

6. The device of claim 1, wherein the sheath assembly further comprises at least one irrigation channel.

7. The device of claim 1, wherein the sheath assembly further comprises at least one aspiration channel.

8. The device of claim 1, wherein the sheath assembly further comprises at least one channel for delivering a therapeutic agent therethrough.

9. The device of claim 1, wherein the sheath assembly is adapted for use with an imaging system.

10. A method of modulating, focusing and directing a cavitational energy emitted from an ultrasonic probe vibrating in a direction transverse to a longitudinal axis of the ultrasonic probe for tissue ablation comprising: enclosing at least a portion of the ultrasonic probe within a sheath assembly comprising a sheath defining at least one fenestration between a proximal end and a distal end of the sheath; inserting the ultrasonic probe into a blood vessel; guiding the ultrasonic probe and the sheath assembly into the blood vessel and to a site of an occlusion; positioning the ultrasonic probe and the sheath assembly such that the at least one fenestration is in proximity with the occlusion; providing an ultrasonic excitation signal to the ultrasonic medical device and transferring the ultrasonic excitation signal along a length of the ultrasonic probe to a flexible probe tip, thereby causing a transverse vibration of the length of the ultrasonic probe and the flexible probe tip and a generation of a plurality of transverse nodes and anti-nodes of the cavitational energy along the length of the ultrasonic probe and the flexible probe tip; and controlling a selective transmission of cavitational energy through the at least one fenestration in the sheath, thereby directing the cavitational energy in an area of the occlusion within the blood vessel to cause fragmentation of the occlusion.

11. The method of claim 10, wherein the sheath assembly is capable of partially shielding tissue at a site of a surgical procedure from the ultrasonic probe.

12. The method of claim 10, further comprising removing at least one fragment of the occlusion through an aspiration conduit of the sheath assembly.

13. The method of claim 10, further comprising supplying an irrigating fluid to the site of the occlusion through an irrigation conduit of the sheath assembly.

14. The method of claim 10, further comprising delivering a therapeutic agent through a conduit of the sheath assembly.

15. The method of claim 10, further comprising positioning the ultrasonic probe proximal to the occlusion using an imaging system.

16. The method of claim 10, comprising manipulating tissue with a tissue manipulation device of the sheath assembly.

17. The method of claim 10, further comprising shielding an ultrasound energy emitted from the ultrasonic probe with the sheath assembly, and visualizing a surgical site with an ultrasound imaging system, the shielding of the ultrasound energy increasing the resolution of the surgical site visualized by the ultrasound imaging system.

18. The method of claim 10, further comprising introducing the sheath assembly from an exterior of a patient to the site of the occlusion, and introducing the ultrasonic probe into the sheath assembly and guiding the ultrasonic probe to a surgical site.

19. A medical device, comprising: an ultrasonic probe configured to emit ultrasonic energy transversely along a portion of the ultrasonic probe; and a sheath comprising a proximal end and a distal end, the sheath at least partially surrounding the ultrasonic probe and defining a fenestration between the proximal and distal ends of the sheath, the sheath being configured to substantially dampen ultrasonic energy such that ultrasonic energy delivered by the medical device is focused toward a region adjacent the fenestration.

20. The medical device of claim 19, wherein the sheath defines a plurality of fenestrations between the proximal and distal ends of the sheath.

21. The medical device of claim 19, wherein the fenestration extends from a proximal end of the sheath to a distal end of the sheath.

22. The medical device of claim 19, further comprising at least one reflective element disposed on an interior surface of the sheath.

23. The medical device of claim 19, wherein the sheath is at least partially surrounded by a second, retractable sheath.

24. The medical device of claim 19, wherein the sheath is constructed to substantially prevent ultrasonic energy from passing therethrough.

25. The medical device of claim 24, wherein the sheath comprises one or more materials that are capable of dissipating ultrasonic energy.

FIELD OF THE INVENTION

The present invention relates generally to a shielded ultrasonic medical probe operating in a transverse mode for ablating and removing undesired tissue. In particular, the invention provides one or more acoustical sheaths for use with the probe, allowing the user to control and focus the energy emitted by the probe in a manner most suited to the desired medical procedure.

BACKGROUND OF THE INVENTION

Ultrasonic energy has been considered for tissue ablation and fragmentation of plaque and thrombosis for removal of intravascular occlusions due to atherosclerotic plaque and intravascular blood clots. Surgical devices utilizing ultrasonic probes for generation and transmission of ultrasonic energy, have been disclosed in the art (U.S. Pat. Nos. 5,112,300; 5,180,363; 4,989,583; 4,931,047; 4,922,902; and 3,805,787). Typically, the energy produced by an ultrasonic probe is in the form of very intense, high frequency sound vibrations, results in fragmentation of tissue (plaque and thrombosis) either as a result of mechanical action thereon or “cavitation” thereof, in which high energy ultrasound frequency applied to liquids generates vapor-filled microbubbles or “cavities” with the concomitant rapid expansion and collapse of the cavities that is accompanied by intense localized hydraulic shock, that causes fragmentation or dissolution of the tissue. Medical applications for ultrasonic probes providing cavitation include surgical procedures for ablation of tissues, for example, treatment of cancer, tissue remodeling, liposuction, and removal of vascular occlusions. Typically, ultrasonic probes described in the art for use in surgical procedures include a mechanism for irrigating an area where the ultrasonic treatment is being performed (e.g., a body cavity or lumen) to wash tissue debris from the area, and may further include an aspiration means to remove irrigation fluid and tissue debris from the site of the procedure. Mechanisms used for irrigation or aspiration described in the art are generally structured such that they increase the overall cross-sectional profile of the probe, by including inner and outer concentric lumens proximal to or within the probe to provide irrigation and aspiration channels. In addition to making the probe more invasive, prior art probes may also maintain a strict orientation of the aspiration and the irrigation mechanism, such that the inner and outer lumens for irrigation and aspiration remain in a fixed position relative to one another, which is generally closely adjacent the area of treatment. Thus, the irrigation lumen would not extend beyond the suction lumen (i.e., there is no movement of the lumens relative to one another) and any aspiration would be limited to picking up fluid and/or tissue remnants within the defined distance between the two lumens.

Ultrasonic probes described in the art for tissue ablation suffer from a number of limitations. Such probes depend on longitudinal vibration of the ultrasonic member comprising the probe i.e. vibration of the probe in the direction of the longitudinal probe axis to effect tissue fragmentation. Probe action in this modality therefore depends primarily on mechanical and thermal action of the probe tip for disrupting tissue, since the cavitational energy emanating from the tip, especially in narrow diameter probes such as those used to remove vascular occlusions, is minimal due to the small surface area of the tip itself. This primary mode of action imposes the following limitations on probe efficiency:

i) tissue ablation is restricted to very small area defined by the surface area of the probe tip, thereby necessitating time consuming surgical procedures to remove relatively large occluded areas with blood vessels in comparison to instruments which excise tissue by mechanical cutting, electrocautery, or cryoexcision methods.

ii) occurrence of late restenosis (typically within three months), and to a lesser extent acute re-occlusion after coronary angioplasty are major clinical problems limiting the long-term efficacy of ultrasonic surgical procedures for treatment of atherosclerosis and coronary angioplasty. While the pathogenosis of restenosis is still unclear, it has been demonstrated from autopsy specimens from patients with restenosis the pathophysiologic process leading to acute occlusion after coronary angioplasty is related either to a thrombotic mechanism or to major plaque dissection and superimposed thrombosis, and that these events leading to chronic restenosis involves vascular injury, platelet deposition and thrombosis and connective tissue synthesis. Such post operative processes are typically result from localized trauma at the surgical site caused by mechanical and thermal action of longitudinally vibrating probes.

Attempts to reduce some of the aforementioned problems associated with longitudinally vibrating probes have been disclosed in the art, wherein the primary action of the probe through longitudinal vibration is supplemented by a limited, supplementary transverse vibration of the probe tip i.e. perpendicular to the longitudinal axis of the probe. It is proposed that such secondary transverse vibrations in these probes will result in increased efficiency for surgical procedures. For example, U.S. Pat. No. 4,961,424 to Kubota, et al. discloses an ultrasonic treatment device that produces both a longitudinal and transverse motion at the tip of the probe. The Kubota, et al. device, however, still relies solely on the tip of the probe to act as a working surface. Thus, while destruction of tissue in proximity to the tip of the probe is more efficient, tissue destruction is still predominantly limited to the area in the immediate vicinity at the tip of the probe. U.S. Pat. No. 4,504,264 to Kelman discloses an ultrasonic treatment device, which improves the speed of ultrasonic tissue removal by oscillating the tip of the probe in addition to relying on longitudinal vibrations. Although tissue destruction at the tip of the device is more efficient, the tissue destroying effect of the probe is still limited to the tip of the probe. Both probes described in Kubota, et al., and Kelman, et al., are further limited in that the energy produced at the tip of the probe is unfocused, the action of the probe tends to push the tissue debris ahead of the probe tip. Likewise, the concentration of energy solely at the probe tip results in heating of the probe tip, which can create tissue necrosis, thereby complicating the surgical procedure and potentially compromising the recovery of the patient. Furthermore, such probes do not eliminate the problems associated with longitudinally vibrating probes.

The aforementioned limitations associated with longitudinally vibrating probes can be overcome entirely by utilizing an ultrasonic probe that vibrates exclusively in the transverse mode. Such probes are capable of generating substantially higher cavitational energy through a plurality of anti-nodes along the entire longitudinal axis of the vibrating probe, thereby eliminating the need for mechanical and thermal action at the probe tip. The advancing probe tip can therefore be shielded to prevent mechanical injury to the walls of the blood vessel for example, thereby precluding scarring, platelet deposition and clotting that lead to restenosis. Additionally, such probes are capable of tissue fragmentation over greater surface area (along the entire longitudinal axis) resulting in high efficiency, thus allowing for rapid surgical procedures and substantially eliminating thermal effects on tissue caused by prolonged probe operation.

Since probe vibrating exclusively in a transverse mode is entirely dependent on cavitational energy for their action, important factors for maintaining efficiency of such probes are (i) narrow probe diameter to facilitate oscillation at lower ultrasonic energies and (ii) increased longitudinal axis (probe length) that results in more cavitation anti-nodes. Although narrow probe diameters are advantages especially for negotiation through narrow blood vessels and occluded arteries, the utilization of such probes have been precluded by inability to effectively control the vibrational amplitude of thin probes, that result in potential damage to the probe and greater risk, of tissue damage resulting from their use. The use of narrow diameter probes have been disclosed in the art for providing greater maneuverability ease of insertion in narrow blood vessels. U.S. Pat. No. 4,920,954 to Allinger discloses a narrow diameter ultrasonic device wherein a rigid sleeve is used to prevent transverse vibrations U.S. Pat. No. 5,380,274 discloses a narrow diameter probe for improved longitudinal vibration having a sheath to inhibit transverse vibration U.S. Pat. No. 5,469,853 to Law discloses a thin, longitudinally vibrating ultrasonic device with a bendable sheath that facilitates directing the probe within narrow blood vessels. While the prior art has focused on the need for using sheaths on thin ultrasonic devices, their use has been entirely to prevent transverse, vibrations of the device and to protect such devices from damage resulting from such vibrations

Based on the aforementioned limitations of ultrasonic probes in the art, there is a need for ultrasonic probe functioning in a transverse mode that further obviates the shortcomings of that further overcomes limitations imposed by of narrow diameter requirements for efficient operation of such probes for rapid tissue ablation. Transversely vibrating ultrasonic probes for tissue ablation are described in the Applicant's co-pending provisional applications U.S. Ser. Nos. 60/178,901 and 60/225,060, and 09/776,015 which further describe the design parameters for such a probe its use in ultrasonic devices for tissue ablation. The entirety of these applications are herein incorporated by reference.

There is a further need for controlling the for procedures which require precise delivery of cavitation energy to defined locations, to be able to restrict the cavitation energy emanating circumferentially from a transversely vibrating p at multiple anti-nodes wastes a portion of the energy given off by the probe, as the energy is unfocused and dispensed along the length of the probe.

There is also a need in the art for a means of focussing the cavitational energy emitted by such a probe to deliver the energy to exactly to the desired location within a blood vessel while shielding the surrounding tissue from damage.

SUMMARY OF THE INVENTION

The present invention is directed towards a transversely vibrating ultrasonic probe for tissue ablating surgical devices that overcomes the aforementioned limitations of ultrasonic probes in the art used for this application. Particularly, the present invention is directed towards providing a means to control, direct and focus the cavitation energy from a transversely vibrating ultrasonic probe by utilizing a sheath assembly extending circumferentially along the longitudinal axis of the probe. In accordance with the present invention, there is provided an ultrasonic probe operating in a transverse mode whereby the probe is cable of vibrating in a direction perpendicular to its longitudinal axis upon application of an ultrasonic frequency, capable of precisely focussing or directing the cavitation energy of the probe to defined regions within a blood vessel. The object of this invention can be accomplished by a transversely vibrating ultrasonic probe described in a co-application submitted by the applicants (###) the entirety of which is herein incorporated by reference.

Further in accordance with the invention, a sheath, a sleeve or other damping member provided with fenestrations is a sheath that is adapted circumferentially along the probe axis, thereby providing control over release of cavitation energy in specific regions along the probe axis. Non-fenestrated areas of the said sheath or sleeve effectively block cavitation energy emanating from the probe from such areas.

Still further in accordance with the invention, a sheath assembly comprising one or more sheaths may can be adapted to the ultrasonic probe, thereby providing a means of containing, focussing, and transmitting energy generated along the length of the probe to one or more defined locations. The sheaths of the present invention also provide the user with a means of protecting regions of tissue from physical contact with the probe. In one embodiment of the invention he sheaths also comprise a means for aspiration and irrigation of the region of probe activity, as well as a means of introducing a drug or compound to the site of probe activity.

In one aspect, a plurality of sheaths are used in combination to provide another level of precision control over the direction of cavitation energy to a tissue in the vicinity of the probe. In one embodiment of the invention, the sheath encloses a means of introducing fluid into the site of the procedure, and a means for aspirating fluid and tissue debris from the site of the procedure. In another aspect the sheath assembly further encloses a means of introducing a drug intravascularly that dissolves clots and prevents the recurrence of stenosis. The ultrasonic oscillation of the probe of the present invention will be used to facilitate the penetration of antithrombogenic agents into the vascular or luminal walls to inhibit restenosis. Preferred antithrombogenic agents include heparin, hirudin, hirulog, urokinase, streptokinase, tPA, and similar agents. In a further embodiment, the probe tip can be moved within the sheath. In yet another aspect, the irrigation and aspiration means, and the probe tip, can all be manipulated and repositioned relative to one another within the sheath. In another embodiment, the sheath is shaped in such a way that it may capture or grasp sections of tissue that can be ablated with the probe.

Still further in accordance with the invention, the sheath provides a guide for the probe tip, protecting tissues from accidental puncture by the sharp, narrow-diameter tip, or from destruction by energy emitted radially from the probe during introduction of the probe to the site. The sheath may be applied either to the probe tip prior to insertion of the probe into the patient, or pre-inserted into the patient prior to the insertion of the probe. The sheath of the present invention can be used to fix the location of one or more shapes relative to the nodes or anti-nodes of a probe acting in transverse action. The location of the reflective shapes can amplify the acoustical wave thereby magnifying the energy. This allows for the use of very small diameter probes which themselves would not have the requisite structural integrity to apply and translate acoustical energy into sufficient mechanical energy to enable ablation of tissues. The reflective shapes can also focus or redirect the energy, effectively converting a transverse probe emitting cavitation energy along its length, to a directed, side fire ultrasonic device.

In a still further aspect of the invention the probe emits transverse ultrasonic energy along its longitudinal axis that may be used to, for example, fragment abnormal cells on the surface of the body cavity which come within the sweep of the probe, or to clear obstructions and constrictions within vasculature or tissue lumen. The device is designed to have a small cross-sectional profile, which also allows the probe to flex along its length, thereby allowing it to be used in a minimally invasive manner. In one aspect, the probe be at least partially contained within the sheath to contain, focus, intensify, and direct the emitted cavitation energy to specific target tissue sites. In another embodiment of the invention, a plurality of sheaths are used in combination to provide another level of precision control over the direction of cavitation energy to a tissue in the vicinity of the probe.

Still further in accordance with the invention, the sheath encloses a means of introducing fluid into the site of the procedure, and a means for aspirating fluid and tissue debris from the site of the procedure. In a further embodiment, the probe tip can be moved within the sheath. In one aspect, the irrigation and aspiration means, and the probe tip, can all be manipulated and repositioned relative to one another within the sheath. In another aspect, the sheath is shaped in such a way that it may capture or grasp sections of tissue that may be ablated with the probe. In yet another embodiment, the sheath provides a guide for the probe tip, protecting tissues from accidental puncture by the sharp, narrow diameter tip, or from destruction by energy emitted radially from the probe. The sheath may be applied to the probe tip prior to insertion of the probe into the patient, or the sheath can be inserted into the patient prior to the insertion of the probe.

The sheath of the present invention can be used to fix the location of one or more shapes relative to the energy nodes or anti-nodes emitted by a transversely vibrating probe. The location of and the particular shape can modulate the energy emitted from the probe at one site, and communicate it to a distant site, for example, it may amplify the acoustical wave at one or more energetic anti-nodes, thereby increasing the energy emitted at the sheath's aperture. This allows for the use of very small diameter probes which themselves would not have the requisite structural integrity to apply and translate acoustical energy into sufficient mechanical energy to enable ablation of tissues. The reflective shapes can also focus or redirect the energy, effectively converting a transverse probe emitting cavitation energy along its length, to for example, a directed, “side-fire” ultrasonic device.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, like reference characters generally refer to the same parts throughout the different views. The drawings shown are not necessarily to scale, with emphasis instead generally being placed upon illustrating the principles of the invention.

FIG. 1 illustrates an exemplary ultrasonic device comprising the ultrasonic probe tip constructed in accordance with the principles of the present invention

FIG. 2 shows the areas of maximum vibrations (anti-nodes) and minimum vibrations (nodes) caused by transverse, vibration of probe and probe tip.

FIGS. 3 a - g show different configurations of sheaths comprising the sheath assembly adapted to the probe.

FIG. 4 shows a probe that is substantially contained within a sheath comprising a plurality of fenestrations.

FIG. 5 shows a probe that is substantially contained within a sheath assembly comprising a plurality of adjustable sheaths.

FIG. 6 shows a longitudinal cross-sectional view of the distal end of the probe comprising a central irrigation passage, lateral irrigation lumens and external aspiration channels.

FIG. 7 shows a transverse cross-sectional view of a portion of the probe illustrating the irrigation and aspiration channels.

FIG. 8 are longitudinal cross-sectional views of the distal end of the probe contained within sheaths incorporating angled reflective elements.

FIG. 9 are longitudinal cross-sectional views of the distal end of the probe contained within sheaths incorporating arctuate of reflective elements

DETAILED DESCRIPTION OF INVENTION

The following terms and definitions are used herein:

“Anti-node” as used herein refers to a region of maximum energy emitted by an ultrasonic probe on or proximal to a position along the probe.

“Cavitation” as used herein refers to shock waves produced by ultrasonic vibration, wherein the vibration creates a plurality of microscopic bubbles which rapidly collapse, resulting in molecular collision by water molecules which collide with force, thereby producing the shock waves.

“Cross-sectional diameter” as used herein refers to the diameter of the cylindrical regions of the probe, including the probe tip.

“Fenestration” as used herein refers to an aperture, window, opening, hole, or space.

“Node” as used herein refers to a region of minimum energy emitted by an ultrasonic probe on or proximal to a position along the probe.

“Probe” as used herein refers to a device capable of being adapted to an ultrasonic generator means, which is capable of propagating the energy emitted by the ultrasonic generator means along its length, and is capable of acoustic impedance causing transformation of ultrasonic energy into mechanical energy.

“Sheath” as used herein refers to an apparatus for covering, encasing, or shielding in whole or in part, a probe or portion thereof connected to an ultrasonic generation means.

“Transverse” as used herein refers to vibration of a probe at right angles to the axis of a probe. A “transverse wave” as used herein is a wave propagated along an ultrasonic probe in which the direction of the disturbance at each point of the medium is perpendicular to the wave vector.

“Tuning” as used herein refers to a process of adjusting the frequency of the ultrasonic generator means to select a frequency that establishes a standing wave along the length of the probe.

The present invention provides an ultrasonic medical device for tissue ablation. More particularly the present invention provides an ultrasonic device comprising a probe capable of vibrating ultrasonically in a transverse mode causing generation of cavitational energy circumferentially around the said probe, comprising a protective sheath assembly adapted over the probe that is capable of focussing, directing and modulating the cavitational energy emitted by the probe. The sheath assembly of the invention allows the user to optimize the tissue ablation efficiency of the probe to suit a particular medical procedure.

The probe of the invention is capable of removing tissue at sites wherein the probe makes actual contact with the tissue, and typically in a region that is radially disposed (approximately 2 mm) from the probe, that corresponds to the region of maximum cavitational energy or “anti-nodes” emanating perpendicular to the longitudinal axis of the probe. By eliminating the axial motion of the probe and allowing transverse vibrations only, fragmentation of large areas of tissue spanning the entire length of the probe due to generation of multiple cavitational anti-nodes along the probe length perpendicular to the probe axis. Since substantially larger affected areas within an occluded blood vessel can be denuded of the occluded tissue in a short time, actual treatment time using the transverse mode ultrasonic medical device according to the invention is greatly reduced as compared to methods using pilot art probes that primarily utilize longitudinal vibration (along probe axis) for tissue ablation. Because the thinnest region of the probe is capable of providing, multiple energy anti-nodes along its length, it is desirable to have a means of modulating this energy, thereby providing a precise way of delivering the energy selectively to desired locations, such as for example an occluded region within a blood vessel, while protecting nearby tissues both from the fragmenting energy and physical damage (for example, punctures) from the narrow diameter probe tip. The probe equipped with a sheath assembly such as that described herein, provides a means for modulating the intensity and direction of energy emitted from such a probe. Additionally, the probe equipped with the sheath assembly of the invention provides a more efficient, selective means of delivering energy from the probe to a specific tissue space, or tissue space, for example at the site of an occlusion within a blood vessel, causing rapid fragmentation and ablation of said tissue without detrimental effect other areas within the vessel.

Probes of the present invention are described in the Applicant's co-pending provisional applications U.S. Ser. Nos. 60/178,901 and 60/225,060 which further describe the design parameters for an ultrasonic probe operating in a transverse mode and the use of such a probe to remodel tissues. The entirety of these applications are herein incorporated by reference.

The present invention allows the selective application of cavitation energy emitted from an ultrasonic probe to tissue. The probe is adapted to an ultrasonic generator means that selectably provides energy over a frequency range of from about 20 kHz to about 80 kHz. In the currently preferred embodiment, the frequency of ultrasonic energy is from 20,000 Hertz to 35,000 Hertz. Frequencies in this range are specifically destructive of hydrated (water-laden) tissues, while substantially ineffective toward high-collagen connective tissue, or other fibrous tissues such as skin or muscle tissues. The amount of cavitation energy to be applied to a particular site requiring treatment is a function of the amplitude and frequency of vibration of the probe, as well as the longitudinal length of the probe tip, the proximity of the tip to a tissue, and the degree to which the probe tip is exposed to the tissues. Control over this last variable can be effectuated through the sheath of the present invention.

A significant advantage of the ultrasonic medical device of the invention is that it physically destroys and removes undesired tissue through the mechanism of cavitation, which is non-thermal. As a consequence, the complications which are arise from thermal destruction or necrosis of tissue are not observed. The increase in local temperature is most likely a result of the heating of the probe. By using the probe contained within a sheath of the present invention the probe is substantially contained and isolated from direct contact with the tissues, thereby enabling destruction of tissues with only a small increase in local temperature, about 7° C. from normal body temperature. The use of a sheath further diminishes or prevents the local temperature rise. Accordingly, In one embodiment, the sheath of the present invention provides a means of insulating surrounding tissue from the thermal side effects of the ultrasonic probe.

The length and diameter of the sheath used in a particular surgical procedure is dependent on the type of probe used, the degree to which the probe length will be inserted into the patient, and the degree of shielding that is required based on the specific areas to be treated. For example, in an application whereby prostate tissue is removed via an intra-urethral route with the ultrasonic probe of the present invention, the sheath must be of a sufficient length to protect the tissue of the urethra, of a sufficient outside diameter to facilitate insertion of the sheath into the urethra, and a sufficient inside diameter capable of accepting the probe. By contrast, for tissue remodeling near, for example, the eye, a probe useful for such a procedure would be significantly shorter and of a significantly smaller diameter, and as such, so would the sheath. The exact dimensions of the sheath including its length and diameter is determined by requirements of a specific medical procedure. Similarly, as illustrated in FIGS. 3 and 4, the position and size of the sheath aperture 111 , or number and positions of the fenestrations 111 , or the presence of a bevel on the sheath terminus 129 to provide a means for tissue manipulations, will likewise be determined by the type of procedure, and the requirements of the particular patient.

In one aspect of the invention, as shown in FIG. 5, the sheath comprises an inner sheath 121 and an outer sheath 108 . The outer sheath may be connected to a retraction trigger (not shown), by one or more articulation means, such as wires, which is capable of moving the outer sheath with respect to the inner sheath. Each wire comprises a first end and a second end. The first end is affixed to the outer sheath 108 , while the second end is affixed to a retraction trigger. When the outer sheath 108 is slid back away from the terminus of the inner sheath 121 the tissues are exposed to cavitation energy emitted by the probe.

In another embodiment, the sheath is flexible. Articulation wires (not shown) comprising two ends, are connected to the sheath and an articulation handle. When the articulation handle is manipulated, for example, pulled axially inward, the flexible sheath will bend or articulate in a bending or articulation direction A, thereby causing the ultrasonic probe to bend or articulate in articulation direction A. In this way, the ultrasonic probe can be used to reach locations that are not axially aligned with the lumen or vessel through which the sheath and probe are inserted.

A particular advantage of the ultrasonic probe operating in transverse mode is that the efficient cavitation energy produced by the probe disintegrates target tissue to small particles of approximately 5 microns in diameter. Because of the operation of the probe, tissue debris created at the probe tip is propelled in a retrograde direction from the probe tip. Accordingly, in another embodiment of the invention, the sheath provides at least one aspiration channel, which can be adapted to a vacuum or suction device, to remove the tissue debris created by the action of the probe. The aspiration channel can be manufactured out of the same material as the sheath provided it is of a sufficient rigidity to maintain its structural integrity under the negative pressure produced by the aspiration means, for example a vacuum pump or other source of negative pressure. Such an aspiration channel is provided either inside the lumen of the sheath, or along the exterior surface of the sheath, or both. In these embodiments, the aspiration channel can be a second hollow sheath nested within the first sheath, or the aspiration channel can be formed in the body of the sheath. A preferred embodiment is shown in FIGS. 6 and 7, whereby the probe 22 itself has one or more grooves defining one or more aspiration channels 60 , and aspiration of tissue debris is effectuated along the probe length between the interior surface of the sheath and the exterior surface of the probe, as directed by the aspiration channels and by retrograde flow from the probe action. FIG. 6 shows a longitudinal cross-section of a portion of an ultrasonic probe 22 and tip 23 according to one embodiment of the invention, comprising a central irrigation passage 17 and lateral irrigation lumens 19 , as well as external aspiration channels 60 . The sheath, not shown, would surround the probe.

In another embodiment, the sheath of the present invention comprises an irrigation channel. The sheath is adapted to an irrigation means, for example, a peristaltic pump or other such device for delivering liquids under controlled flow rates and pressures, and the sheath directs fluid to the location of the probe. The irrigation channel can be manufactured out of the same material as the sheath provided it is of a sufficient rigidity to maintain its structural integrity under the positive pressure produced by the flow of fluid produced by the irrigation means. Such an irrigation channel is provided either inside the lumen of the sheath, or along the exterior surface of the sheath, or both. In these embodiments, the irrigation channel can be a second hollow sheath nested within the first sheath, or the irrigation channel can be formed in the body of the sheath. In one embodiment, the probe itself has one or more grooves defining irrigation channels, and fluid is directed along the probe length between the interior surface of the sheath and the exterior surface of the probe, as directed by the irrigation channels. In this embodiment, irrigation fluids provide a means of cooling the probe. The sheath itself, or an irrigation sheath contained within the first sheath can provide a means of introducing a drug or pharmaceutical formulation to the site of probe activity. For example, anti-thrombolytic drugs such as heparin, streptokinase, tPA, urokinase, hirulog, or hirudin may be introduced to the site of a vascular occlusion through the sheath. The ultrasonic energy further provides a means for assisting the drug in penetrating the occlusion.

In yet another embodiment, the sheath of the present invention further comprises both an irrigation and an aspiration channel. As in the above embodiments, the channels may be located within the sheath lumen, or exterior to the sheath, or a combination of the two, and can be proximal or distal to the other channel provided they are not in direct communication. Likewise, in these embodiments the probe itself has a plurality of grooves defining aspiration channels and irrigation channels, and fluid is directed along the probe length between the interior surfaces of the sheaths and the exterior surface of the probe, as directed by the aspiration and irrigation channels. In another aspect of the invention, the sheath comprises a means for directing, controlling, regulating, and focussing the cavitation energy emitted by the probe, an aspiration means, an irrigation means, or any combination of the above.

In yet another embodiment, as shown in FIG. 8, the sheath is a device that allows for the manipulation of tissues, comprising a surface that is capable of manipulating tissues near the site of the probe. In this aspect, the terminus of the sheath may be closed, such that the sheath insulates tissues from the destructive energy emitted by the probe and can be used to push tissues away from the aperture 111 , thereby allowing proximal tissues to be exposed to the probe 22 and 23 . Alternatively, the sheath comprises a beveled or arcutate surface at the sheath terminus 129 , capable of providing a means for hooking, grasping, or otherwise holding a tissue in proximity to the probe 22 and 23 . In another embodiment, the sheath allows for the introduction of another surgical device, for example, flexible biopsy forceps, capable of manipulating tissues into a tissue space, such that the surgical device can hold the tissue in proximity with the probe.

In a further embodiment, the internal surface of the sheath provides a means to amplify or focus cavitation energy from the probe 22 . In this aspect, the interior surface of the sheath comprises at least one structure or reflective element 118 , that extends into the sheath lumen. The reflective element maybe planar, or arcutate, or a combination of these shapes. Reflective elements of the present invention may be fabricated from the same material as the sheath, or may use different materials that optimize the reflective properties of the elements. Since the cavitation energy reaches a maximum at anti-nodes along the probe, the interval of the anti-nodes being determined by the ultrasonic frequency at which the generator operates, the spacing of the reflective elements in the sheath is determined by the intended operating frequency of the ultrasonic device. Similarly, the number of anti-nodes along the probe 22 , is determined by the length of the probe and the frequency. As such, the number of reflective elements is determined by the length of the probe and the operating frequency. For example, an ultrasonic device operating at a frequency of approximately 25 kHz employing a probe with a length at the thinnest interval 22 of about 3 centimeters, will display about seven anti-nodes approximately 2 millimeters wide, spaced about 2 millimeters apart. Energy will radiate circumferentially around the probe at these anti-nodes. A sheath useful with such a probe would comprise, for example but not limited to, a cylindrical sheath about at least 3 centimeters in length further comprising seven reflective elements, approximately 2 millimeters wide, spaced about 2 millimeters apart, positioned with respect to the probe such that the reflective elements 118 , are centered over the anti-nodes. Since the energy emitted by the probe radiates circumferentially from an anti-node, the reflective elements can extend radially from the interior, wall of the sheath into the sheath lumen, for example, 270 degrees around the interior of the sheath, while the remaining 90 degrees has no reflective element and thereby provides a means for channeling the cavitation energy from the anti-node to a position distal to the anti-node. The channeling means of the present example maybe a region where no reflective element is present, or where the shape or angle is altered compared to the reflective element, or any other such means of directing energy from the area of the anti-node to a position distal to the anti-node.

The sheath of the present invention may comprise a means of viewing the site of probe action. This may include an illumination means and a viewing means. In one embodiment, the sheath of the present invention comprises a means for containing or introducing (if external to the sheath) an endoscope, or similar optical imaging means. In another embodiment of the invention, the ultrasound medical device is used in conjunction with an imaging system, for example, MRI, or ultrasound imaging—in particular color ultrasound. In this embodiment, the action of the probe echogenically produces a pronounced and bright image on the display. The sheath in this embodiment shields the probe, thereby reducing the intensity of the probe image and enhancing the resolution of the image by decreasing the contrast between the vibrating probe and the surrounding tissues.

In yet another embodiment, the sheath assembly of the present on may be provided along with an ultrasonic probe in the form of a kit. In this aspect, the probe for a particular surgical procedure is provided, along with the correct sheath, as well as instructions for assembling and tuning the probe, and the appropriate frequency range for the procedure. The probe and sheath may be packaged preassembled, such that the probe is already contained within the sheath and the respective position of the probe within the sheath is optimized such that any reflective elements in the sheath would be correctly aligned with the prospective position of the anti-nodes for a given frequency, the kit further comprising instructions for the appropriate frequency. The kit may further comprise packaging whereby the probe and sheath are pre-sterilized, and sealed against contaminants. In a preferred embodiment, the probe and sheath are provided in a container that complies with regulations governing the storage, handling, and disposal of sharp medical devices. Such a container is capable of receiving and securing the probe and sheath before and after use. In one aspect, the sharps container provides a means of affixing the probe and sheath assembly to an ultrasonic medical device without direct manipulation of the probe and sheath assembly, and a means for removing the assembly from the ultrasonic medical device after use. In another aspect, the kit comprises a probe and sheath assembly contained within a sterile sharps container that further comprises a single use locking means, whereby the probe and sheath assembly is affixed to the ultrasonic medical device solely through the sharps container, are removed from device solely through the container, and once removed can not be re-extracted from the sharps container.

Referring now to FIG. 1, a transverse mode ultrasonic medical device comprising an elongated probe 6 which is coupled to a device providing a source or generation means for the production of ultrasonic energy (shown in phantom in the Figure as 66 ) constructed in accordance with the present invention is illustrated. The generation source may or may not be a physical part of the device itself. The probe 6 transmits ultrasonic energy received from the generator along its length. The probe is capable of engaging the ultrasonic generator at one terminus with sufficient restraint to form an acoustical mass that can propagate the ultrasonic energy provided by the generator. The other terminus of the probe comprises a tip 22 , which has a small diameter, enabling the tip to flex along its longitude. In one embodiment of the invention, the probe diameter decreases at defined regional or segment intervals 14 , 18 , 20 , and 22 . Energy from the generator is transmitted along the length of the probe, causing the probe segments 22 and 23 at the distal end to vibrate in a direction that is transverse to the probe longitudinal axis. In this embodiment, one of the probe intervals 18 has at least one groove 45 for engaging the locking assembly of a probe disposal container.

Referring now to FIG. 2, the terminal segment 22 and tip 23 of the probe are illustrated, wherein transverse vibration caused by application of ultrasonic energy to the probe generates alternating areas of maximum vibration, or “anti-nodes” 24 , along the length of the probe segment 22 and tip 23 , and “nodes,” or areas of minimum vibration 25 , at repeating intervals along said segment and tip. The number of anti-nodes, and their spacing along the probe depends on the frequency of the energy produced by the ultrasonic generator, while the separation of nodes and anti-nodes is a function of harmonic intervals of the frequency, and can be affected by tuning the probe. In a properly tuned probe, the anti-nodes will be found at a position exactly one half of the distance between the nodes. Tissue-destroying effects of the device are not limited to regions coming into direct contact with probe tip 23 , but rather, as the probe is moved through the area where ablation is desired, tissue is removed in areas adjacent to the multiplicity of anti-nodes produced along the entire length of the probe. The magnitude of the cavitation energy produced by the probe tip is such that it extends outward from the probe tip at the anti-nodes from about 1-2 millimeters.

Referring now to FIGS. 3 a - g , sheath assemblies comprising different configurations of dampening sheaths for the ultrasonic probe 6 are illustrated. FIG. 3 a shows a transverse mode probe 6 is shown comprising a semi-cylindrical sheath 107 , which partially contains the probe. For purposes of illustration, the probe 6 is visible beneath the sheath. The sheath 107 is of a sufficient diameter, so as to at least partially encompass the probe. In the semi-cylindrical embodiment shown, the circumference of the sheath is approximately 180 degrees, and the length is sufficient to span a plurality of intervals 20 and 22 over the probe. FIG. 3 b shows a semi-cylindrical sheath 107 (also shown in FIG. 2), and a second concentric sheath 108 that is cylindrical, and is capable of containing the first sheath 107 , as well as the probe 6 . FIG. 3 c shows the sheath 121 having a cylindrical structure of a sufficient diameter to contain the probe 6 , made visible for the purpose of illustration. Sheath 121 comprises at least one fenestration 111 , which allows the cavitation energy emitted from the probe tip to be communicated to an area outside the sheath, through the said fenestration; probe energy from areas wherein the probe is not exposed by a fenestration is contained by the sheath. FIG. 3 d shows the hollow cylindrical sheath 121 containing a plurality of arcutate fenestrations 111 . FIG. 3 e illustrates a longitudinal view of probe 6 contained within a sheath 121 which comprises a plurality of arcutate fenestrations 111 , and at least one acoustic reflective element 122 , that is adapted to the interior surface of the sheath. FIG. 3 f shows a sheath 121 further comprising two semi-cylindrical halves 109 , each half connected to the other by one or more connecting means 113 . The probe 6 is capable of being substantially contained within the sheath. The cavitation energy generated by the probe tip 22 is contained by the semi-cylindrical halves 109 , where they occlude the probe tip. FIG. 3 g illustrates a sheath further comprising of at least two cylinders 104 , each cylinder connected to the other by at least one connecting means 113 . The probe 6 is capable of being substantially contained within the sheath. The cavitation energy generated by the probe tip 22 is contained by cylinders 104 , where they occlude the probe tip.

Referring now to FIG. 4, a segment 20 of a probe is substantially contained in a sheath 121 comprising a plurality of fenestrations 111 . Release of cavitation energy emitted by the probe 20 , to the environment is controlled by sheath 121 and is communicated to the outside of the sheath through the fenestrations.

Referring now to FIG. 5, the distal end of the probe of ultrasonic medical device contained in a sheath assembly is illustrated. The probe 6 is substantially contained within a cylindrical sheath 121 capable of modulating the energy omitted by an active probe, and shielding tissues from puncture from a sharp probe tip. The sheath 121 shown in this illustration has been modified such that one of the terminal ends of the sheath is substantially open, defining a fenestration or aperture 111 , which exposes the probe tip 22 and 23 . The terminus of the sheath 129 is shaped to provide a means for manipulating tissue to bring it into proximity with the probe 22 and 23 . A second concentric cylindrical sheath 108 which surrounds a portion of the first sheath 121 , that can be manipulated longitudinally along the first sheath to provide a means for modulating the exposure of the probe tip 22 and 23 by partial closure of the aperture 111 , thereby modulating the cavitation energy emitted by the probe to which occlusion materials will be exposed.

Referring now to FIG. 6, a longitudinal cross-section of a portion of an ultrasonic probe tip 22 and 23 is shown, comprising a central irrigation passage 17 , lateral irrigation lumens 19 , and as external aspiration channels 60 .

Referring now to FIG. 7, a transverse cross-sectional view of a portion of the ultrasonic probe shown. The probe 6 comprises a plurality of arcutate channels 60 that extend over the longitudinal length of the probe tip, providing a conduit for irrigation and or aspiration of tissue debris and fluid.

Referring now to FIG. 8, sheath comprising a fenestration 111 allowing communication of the cavitation energy emitted by the probe to the outside of the sheath is shown. The interior of the sheath further comprises reflective elements 118 , shown as a plurality planar surfaces that extend from the interior wall of the sheath into the lumen, thereby providing a means for focusing and redirecting cavitation energy emitted by the probe tip. In embodiment, the terminus of the sheath 129 is shaped to provide a tissue manipulation means.

Referring now to FIG. 9, a sheath comprising a fenestration 111 allowing communication of the cavitation energy emitted by the probe to the outside of the sheath is shown. The interior of sheath 121 containing the probe 22 and 23 comprises reflective elements 118 that are arcuate, and contain a plurality of fenestrations 111 .

Sheath materials useful for the present invention include any material with acoustical or vibrational dampening properties capable of absorbing, containing, or dissipating the cavitation energy emitted by the probe tip. Such materials must be capable of being sterilized by, for example, gamma irradiation or ethylene oxide gas (ETO), without losing their structural integrity. Such materials include but are not limited to, plastics such as polytetrafluoroethylene (PTFE), polyethylene, polypropylene, silicone, polyetherimide, or other such plastics that are used in medical procedures. Ceramic materials can also be used, and have the added benefit that they may be sterilized by autoclaving. Combinations of the aforementioned materials can be used depending on the procedure, for example as in the sheath of FIG. 5, a ceramic sheath 121 can be used in combination with a moveable PTFE outer sheath 108 . Alternatively a single sheath may employ two or more materials to give the desired combination of strength and flexibility, for example, the sheath may comprise a rigid ceramic section distal to the probe tip 23 and a more flexible plastic section proximal to the tip, capable of flexing with the probe 22 . In the currently preferred embodiment of the invention, PTFE is used to fabricate a strong, flexible, disposable sheath that is easily sterilized by irradiation or ETO gas.

It should be obvious to those of ordinary skill in the art that the individual features described herein may be combined. Variations, modifications, and other implementations of what is described herein will occur to those of ordinary skill in the art without departing from the spirit and scope of the invention as claimed. Accordingly, the invention is to be defined not by the preceding illustrative description but instead by the spirit and scope of the following claims.